scholarly journals Anaemic retinopathy in megaloblastic anaemia

2020 ◽  
Vol 12 (2) ◽  
pp. 313-316
Author(s):  
Pradeep Pakalapati ◽  
Afrin Shanwaz
Keyword(s):  
Megaloblastic Anaemia ◽  
Ophthalmological Examination ◽  
Ocular Manifestations ◽  
Cotton Wool Spots ◽  
Corrected Visual Acuity ◽  
Progression Of Disease ◽  
Haematological Disorders ◽  
Systemic Examination ◽  
The Right ◽  
Optic Discs

Introduction: Anaemias are the commonest haematological disorders which cause ocular manifestations. With the progression of disease, retinal haemorrhages, dilated and tortuous veins, cotton wool spots may occur in the ocular fundus. Case: An 18-year-old female patient presented to our out patient department with the sudden, painless, non-progressive blurring of vision in both eyes (best-corrected visual acuity in the right eye is 6/60, and left eye is 6/36) for two days. On Ophthalmological examination, bilateral pale tarsal conjunctiva, yellowish discolouration of the sclera, hyperemic optic discs, macular haemorrhages, superficial and deep haemorrhages with Roth spots were observed. The haematological evaluation showed the presence of Megaloblastic anaemia (with haemoglobin - 2.5g%). There was severe pallor on general examination. Mild hepatomegaly and splenomegaly were noted on the systemic examination and confirmed by ultrasound abdomen. Intraocular pressure was 11 mmHg in both eyes. Conclusion: This case documents the occurrence of bilateral macular haemorrhages and Roth spots in megaloblastic anaemia without thrombocytopenia. Other causes of Roth spots were excluded. Treatment of anaemia showed resolution of Roth spots.

scholarly journals Resolution of grade IV hypertensive retinopathy in an adult with pheochromocytoma: post-tumor resection

2020 ◽  
Vol 13 (2) ◽  
pp. e231245
Author(s):  
Aparajita Banerjee ◽  
Bhagabat Nayak ◽  
Gargi Verma ◽  
Sucheta Parija
Keyword(s):  
Blood Pressure ◽  
Tumor Resection ◽  
Hypertensive Retinopathy ◽  
Corrected Visual Acuity ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Hypertensive Woman ◽  
Systemic Examination ◽  
The Right

A 64-year-old hypertensive woman presented with complaints of a painless, progressive decrease in vision, headache, dizziness for the last month. She was a known case of diabetes mellitus on insulin therapy. On examination, best-corrected visual acuity was 6/12 in the right eye and 6/18 in the left eye. The fundus examination in both eyes revealed features of grade IV hypertensive retinopathy. Systemic examination revealed the raised blood pressure of 200/110 mm Hg. Diagnosis of pheochromocytoma was made on the basis of increased urinary norepinephrine (892.8 mg/dL) and mass in the left adrenal gland (measuring 31×28 mm) at contrast-enhanced CT. Medical management to control hypertension was done and ultimately, she underwent left laparoscopic adrenalectomy. After 10 months of surgery, the patient was asymptomatic, blood pressure was within normal limit and her vision improved to 6/6 in both the eyes. The retinal features of hypertensive retinopathy had completely disappeared.

scholarly journals To evaluate ocular manifestations in primary hypertension

2021 ◽  
Vol 7 (2) ◽  
pp. 200-203
Author(s):  
Durgesh Kumar Sinha ◽  
Rani Sujatha MA
Keyword(s):  
Blood Pressure ◽  
Severe Hypertension ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Ophthalmological Examination ◽  
Hard Exudates ◽  
Ocular Manifestations ◽  
Progression Of Disease ◽  
Irregular Reflection ◽  
Arteriolar Narrowing

To evaluate ocular manifestations in primary severe hypertension.: A retrospective chart review of 100 eyes of 50 patients in age group 45-60 years diagnosed with primary severe hypertension (systolic blood pressure [SBP] ≥ 180 mm Hg and diastolic blood pressure [DBP] ≥ 110 mm of Hg) in a tertiary hospital in 6 months from December 2018 to May 2019. Vision with evaluated with Snellen’s chart, fundus was examined with IDO, DO, +90D, +20 D lens and OCT was done.: Mean age were found to be 51 years ±9.8 under treatment for essential hypertension. Fundus findings included Arteriolar Narrowing (both Focal and Generalized arteriolar Narrowing), Hard Exudates, Cotton Wool Patches, Flame Shaped Haemorrhages, Optic disc edema, Disc haemorrhages. OCT findings included Macular Oedema, Irregular reflection, Sub Retinal Fluid, Inner Retinal Fluid, Hyper Reflective Dots.: This study can be used as an early diagnostic tool in hypertension. Severe hypertension may lead to may exudative changes. With Arteriolar Narrowing and Hyperreflective Dots within retina as the most common findings. Awareness should be spread regarding ophthalmological examination among patients so that timely measures can be initiated to stop the progression of disease.

scholarly journals Retinal involvement in acute thrombotic thrombocytopenic purpura: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. G. N. M. K. Bandara ◽  
Anne Thushara Matthias
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Ophthalmological Examination ◽  
Cotton Wool ◽  
Thrombocytopenic Purpura ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
Cotton Wool Spots ◽  
Life Threatening ◽  
History Of ◽  
Nonspecific Sign

Abstract Background Thrombotic thrombocytopenic purpura (TTP) is a life-threatening hematological condition associated with deficiency in ADAMTS13. Ocular manifestations associated with TTP are uncommon. Case presentation Here we report a case where a 44 year old female patient with a history of symptomatic anemia and cotton wool appearance in retina during ophthalmological examination and subsequently, she was diagnosed to have TTP. The proper management with Therapeutic Plasma Exchange (TPE) and IV methylprednisolone improved the condition of the patient markedly. Conclusion It concludes that even though the presence of cotton wool appearance in retina is a nonspecific sign it needs to be properly evaluated as there can be underlying serious illnesses as in our patient. Cotton wool spots can be an early sign of underlying retinal compromise and it should be identified early.

scholarly journals A rare case of bilateral ocular manifestations of Sturge-Weber syndrome

2021 ◽  
Vol 9 (12) ◽  
pp. 3721
Author(s):  
Pranami Basyach
Keyword(s):  
Normal Limit ◽  
Retinal Nerve Fibre Layer ◽  
Ocular Manifestations ◽  
Corrected Visual Acuity ◽  
Weber Syndrome ◽  
Operative Complications ◽  
Sturge Weber Syndrome ◽  
Nerve Fibre Layer ◽  
Systemic Examination

Sturge–Weber syndrome (SWS) is a group of phakomatoses characterized by hamartomas involving brain, skin and eyes. A 36 years old female presented with pain and diminution of vision in both eyes since last 1 year. On examination she has bluish sclera in B/L eyes with characteristic facial port-wine stain. Best corrected visual acuity (BCVA) in R/E- 6/18, N6 and in L/E- 6/6, N6. Intra-occular pressure (IOP) in R/E – 27 mm Hg and in L/E –18 mmHg. On gonioscopy – open angle B/E. On direct ophthalmoscopy and slit-lamp examination with 90 D lens, cup-disc ratio in R/E – 0.9 and in L/E – 0.7 with thinning of neuro-retinal rim in B/E. In optical coherence tomography (OCT), retinal nerve fibre layer (RNFL) and optic nerve head (ONH) it was confirmed. Other systemic examination – within normal limit. Initially, she had been on conservative treatment. As intraocular pressure remained high after several weeks of treatment, trabeculectomy in R/E done under local anaesthesia. No post-operative complications were seen. After 7 days of follow-up IOP – within normal limit, vision in R/E unchanged and had been frequently followed-up.

scholarly journals Levator palpabrae superioris myositis as an unusual cause of unilateral ptosis—case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed M. Abdrabou
Keyword(s):  
Previous History ◽  
Good Prognosis ◽  
Oculomotor Nerve Palsy ◽  
Ophthalmological Examination ◽  
Bilateral Ptosis ◽  
Mri Findings ◽  
Upper Eyelid ◽  
Unilateral Disease ◽  
The Right ◽  
Mri Study

Abstract Background Ptosis can be a manifestation of a more serious situation. Hence, the analysis of the complaint and the search for etiology are crucial in such cases. Ptosis has many causes; some of them lead to unilateral ptosis while others cause bilateral ptosis. For instance, myasthenia gravis is a cause of bilateral ptosis while oculomotor nerve palsy induces unilateral disease. Proper evaluation of the patient and identification of the cause are important to achieve accurate management and good prognosis. Case presentation A 47-year-old male patient attended the ER complaining of dropping the right eye lid of 2 days’ duration. There was no associated pain or diplopia. On examination, the extraocular muscles’ (EOM) motility was intact, normal pupil and corneal reflexes, and there was swelling of the upper eyelid. Ophthalmological examination revealed normal anterior and posterior chambers as well as the vitreous and retina. The patient had a previous history of traumatic intracranial hemorrhage that was resolved without surgical intervention. He also had diabetes mellitus and hypertension. The patient was transferred to the MRI unit to perform MRI study of the brain and orbit with MRA and IV contrast administration. MRI findings confirmed the diagnosis of LPS myositis, and the patient received medical treatment and improved. Conclusion Proper radiological diagnosis leads to accurate management and achieves rapid recovery and optimal patient care.

scholarly journals “Old wine in a new bottle” - post COVID-19 infection, central serous chorioretinopathy and the steroids

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Srinivasan Sanjay ◽  
Poornachandra B. Gowda ◽  
Bhimasena Rao ◽  
Deepashri Mutalik ◽  
Padmamalini Mahendradas ◽  
...  
Keyword(s):  
Virus Disease ◽  
Anterior Segment ◽  
Central Serous Retinopathy ◽  
Oral Antibiotics ◽  
Rt Pcr ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
The Right

Abstract Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

Sudden onset blindness treated with pulse steroid therapy in a patient with microscopic polyangiitis

Open Medicine ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 631-633
Author(s):  
Yoshiro Horai ◽  
Tomoya Miyamura ◽  
Karin Shimada ◽  
Soichiro Takahama ◽  
Rumi Minami ◽  
...  
Keyword(s):  
Steroid Therapy ◽  
Microscopic Polyangiitis ◽  
Oral Prednisolone ◽  
Sudden Onset ◽  
High Dose ◽  
Pulse Steroid Therapy ◽  
Ocular Manifestations ◽  
Dose Oral ◽  
The Right ◽  
Pulse Steroid

AbstractWe report a 71-year-old male with microscopic polyangiitis (MPA) who developed sudden-onset, progressive, bilateral visual loss associated with a relapse of MPA symptoms. The patient was referred to our hospital, and treated with intravenous pulse steroid therapy and high-dose oral prednisolone. Although the right eye remained vision deficient, visual acuity in the left eye recovered. Ocular manifestations of MPA are quite uncommon. This case emphasizes the necessity of early detection and initiation of prompt therapy where ocular manifestations of MPA occur.

Non-central serous chorioretinopathy in a patient with systemic lupus erythematosus and hydroxychloroquine retinopathy

2021 ◽  
Vol 14 (1) ◽  
pp. e237243
Author(s):  
Diogo Hipolito-Fernandes ◽  
Maria Elisa Luís ◽  
Rita Flores ◽  
Rita Anjos
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Central Serous Chorioretinopathy ◽  
Vision Loss ◽  
Subretinal Fluid ◽  
Ophthalmological Examination ◽  
Systemic Lupus ◽  
Diagnostic Challenge ◽  
Hydroxychloroquine Retinopathy ◽  
The Right

Subretinal fluid accumulation in a patient with systemic lupus erythematosus (SLE) may represent a diagnostic challenge. We present a case of a 43-year-old man with baseline diagnosis of SLE and hydroxychloroquine-associated maculopathy who reported progressive vision loss on the right eye, associated with corticosteroids use for an arthritic crisis. Ophthalmological examination did not reveal any acute finding. On optical coherence tomography, subretinal fluid in the perifoveal area was visible on the right eye, with corresponding enlargement of the visual field defect. An increased choroidal thickness was also visible. Fluorescein angiography revealed, on the right eye, two pinpoint areas of leakage and indocyanine green angiography signs of choroidal vascular hyperpermeability. Considering a diagnosis of a non-central central serous chorioretinopathy, corticosteroids use was interrupted, with resolution of the subretinal fluid. This case illustrates the relevance of a multimodal imaging approach to guide the diagnosis of patient with an SLE with subretinal fluid.

scholarly journals Ambliopia anisometropia

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Laya Rares
Keyword(s):  
Ophthalmological Examination ◽  
Blurred Vision ◽  
Anisometropic Amblyopia ◽  
Main Complaint ◽  
Maddox Rod ◽  
The Right ◽  
Test Cover ◽  
Myopic Astigmatism ◽  
Distance Fixation ◽  
Cover Test

Abstract: Anisometropic amblyopia is blurred vision due to refractive anomaly without any anatomical disorders of the eyes. It is frequently found among children in their growth and development periods. The prognosis depends on the ambylopia severity, management, patient’s obedience to the management, and age. We report a case of anisometropic amblyopia in a 8-year-old boy with his main complaint was blurred vision of both eyes. The ophthalmological examination showed the visual acuity of both eyes 6/40, PH 6/9. Several tests that showed normal results were as follows: eyeball movements to all directions; pupil responses to light; Hischberg test; cover test dan cover uncover test at near and far distance fixation; alternate cover test; and worth four dots and Maddox rod tests. Cyclopegical refraction with streak retinoscopy at 50 cm distance resulted in right eye S-4.00 C-3.00 x1800 6/9 and left eye S-1.25 C-3.25 x1800 6/7.5; autorefraction of right eye S-4.50 C-3.25 x70 and of left eye S-1.25 C-4.25 x1710. Anterior and posterior segments of both eyes were normal. Conclusion: In this case, the diagnosis was confirmed as anisometropic amblyopia and compound myopic astigmatism of the right and left eyes. The prognosis was dubia ad bonam. The patient was treated with maximal correction glasses and observed for the first four weeks, and then would be evaluated continuously untill the vision was normal. Keywords: amblyopia anisometropia, vision, refraction anomalyAbstrak: Ambliopia anisometropia merupakan gangguan penglihatan akibat kelainan refraksi tanpa disertai adanya kelainan anatomik pada mata yang sering terjadi pada masa perkembangan anak. Prognosis sangat tergantung pada derajat ambliopia, penanganan, kepatuhan pasien terhadap penanganan, dan usia pasien. Kami melaporkan kasus ambliopia anisometropia pada seorang anak berusia 8 tahun, dengan keluhan utama penglihatan kedua mata kabur. Dari pemeriksaan oftalmologik didapatkan visus ODS 6/40, PH 6/9. Beberapa pemeriksaan yang dilakukan memperlihatkan hasil normal, yaitu: pergerakan bola mata ke segala arah; respon pupil terhadap cahaya; Hischberg test; cover test dan cover uncover test pada fiksasi jarak dekat dan jauh; alternate cover test; serta worth four dots test dan Maddox rod test. Pemeriksaan refraksi sikloplegik dengan streak retinoscopy pada jarak 50 cm didapatkan mata kanan S-4,00 C-3,00 x1800 6/9 dan mata kiri S-1,25 C-3,25 x1800 6/7,5 dan pemeriksaan autorefraksi mata kanan S-4,50 C-3,25 x70 dan mata kiri S-1,25 C-4,25 x1710. Pemeriksaan segmen anterior dan posterior mata kanan dan kiri dalam batas normal. Simpulan: Diagnosis pada kasus ini ialah ambliopia anisometropia ODS dan astigmatisma miopikus kompositus ODS, dengan prognosis dubia ad bonam. Terapi yang diberikan ialah kacamata koreksi maksimal dan diobservasi selama 4 minggu pertama, dan akan dievaluasi terus sampai ketajaman penglihatan normaL. Kata kunci: ambliopia anisometropia, ketajaman penglihatan, kelainan refraksi

scholarly journals Subcutaneous Emphysema in Pregnancy

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
A Shrestha ◽  
S Acharya
Keyword(s):  
Subcutaneous Emphysema ◽  
Late Pregnancy ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Normal Chest ◽  
Chest X Ray ◽  
Keywords Pregnancy ◽  
Systemic Examination ◽  
The Right

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice. Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.

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