scholarly journals Bilateral central serous chorio-retinopathy in pregnancy presenting with severe visual loss

2014 ◽  
Vol 6 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Chandana Chakraborti ◽  
Swapan Kumar Samanta ◽  
Khandakar Faiduddin ◽  
Krittika Pal Choudhury ◽  
Sheuli Kumar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment ◽  
Third Trimester ◽  
Retinal Pigment Epithelial Detachment ◽  
Serous Macular Detachment ◽  
Macular Detachment ◽  
Severe Visual Loss ◽  
Finger Counting ◽  
Funduscopic Examination ◽  
The Right

Introduction: Bilateral central serous chorio-retinopathy is an unusual presentation.  Objective: To report a case of pregnancy-induced bilateral central serous chorio-retinopathy. Case: A thirty-year-old woman complaining of reduced vision in both the eyes was referred for ophthalmoscopic evaluation in her third trimester of pregnancy. The best-corrected visual acuity was 6/60 in the right eye and finger counting at four meters in the left. The funduscopic examination revealed serous macular detachment with white sub-retinal exudates in both the eyes. Optical coherence tomography sections through the macula demonstrated serous elevation of the retina and retinal pigment epithelial detachment in both the eyes. The serous macular detachment resolved and the patient recovered to the visual acuity of 6/6 in both the eyes after twelve weeks of delivery. The OCT showed resolution of the sub-retinal fluid and disappearance of the sub-macular exudate in the right eye, but the resolution was partial in the left eye.Conclusion: Pregnancy is a risk factor for CSCR and it can present with severe bilateral visual diminution.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11711Nepal J Ophthalmol 2014; 6(12): 220-223 

scholarly journals A Patient With Optic Nerve Pit Maculopathy Successfully Treated With Juxtapapillary Laser Photocoagulation

2021 ◽  
Author(s):  
Homayoun Nikkhah ◽  
Iman Ansari ◽  
Kiana Hassanpour
Keyword(s):  
Optic Nerve ◽  
Optic Disc ◽  
Laser Photocoagulation ◽  
Systemic Hypertension ◽  
Serous Macular Detachment ◽  
Abnormal Finding ◽  
Macular Detachment ◽  
History Of ◽  
Funduscopic Examination ◽  
The Right

Optic disc pits are rare and congenital or acquired anomalies of the optic disc, usually remaining asymptomatic. However, serous macular detachment or optic disc maculopathy is the most common complication, causing significant visual deterioration, without a current consensus about treatment. A 55-year-old woman with a past medical history of diabetes mellitus and systemic hypertension was referred for an abnormal finding in the retina. The Corrected Distance Visual Acuity (CDVA) was 20/40 in the right eye and 20/30 in the left eye. Marcus-Gunn was negative and Slit-lamp biomicroscopy revealed no pathologic findings in both eyes. Funduscopic examination showed an excavation in the inferotemporal part of the Optic Nerve Head (ONH) with serous macular detachment extending to the optic disc. Based on clinical examination and paraclinical imaging fluorescein Angiogeraphy (FAG) Optical Coherence Tomography (OCT), optic pit maculopathy was diagnosed and the patient underwent Juxtapapillary Laser Photocoagulation (JLP). After 2 years of follow-up, there were anatomical and functional improvements.

First Clinical Experience with Anti-myelin Oligodendrocyte Glycoprotein Antibody-Positive Optic Neuritis

2020 ◽  
Vol 237 (04) ◽  
pp. 458-463 ◽  
Author(s):  
Jan Heckmann ◽  
Margarita Todorova ◽  
Stefanie Müller ◽  
Philip Julian Broser ◽  
Veit Sturm
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Pulse Therapy ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Individual Treatment ◽  
Igg Antibodies ◽  
Intravenous Methylprednisolone ◽  
Finger Counting ◽  
The Right

Abstract Background Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been consistently found in a range of demyelinating disorders. In this context, MOG-IgG-associated optic neuritis (ON) has been suggested as a new subset of optic neuropathy. However, clinical manifestations and distinctive characteristics have only rarely been described. Patients and Methods A retrospective case series of three patients with MOG-IgG-associated ON. Clinical morphological features using imaging techniques are presented. Results Three patients (8-year-old boy, 28-year-old female, 48-year-old male) were included. An 8-year-old boy suffered from a bilateral ON with severe visual loss. The best-corrected visual acuity (BCVA) was 0.05 in the right eye and finger counting in the left eye. The patient had a previous episode of acute disseminated encephalomyelitis (ADEM) with a right abducens nerve palsy. Visual acuity recovered after repeated cycles of intravenous methylprednisolone pulse therapy and 10 cycles of plasma exchange. During the last follow-up, BCVA was 0.9 in the right eye and 0.8 in the left eye. A 28-year-old female presented with a bilateral ON. Her BCVA was 0.5 in the right eye and 0.8 in the left eye. She fully recovered with pulse methylprednisolone therapy (1000 mg/d) with tapering after the second cycle and had a BCVA of 1.0 during the last follow-up visit. A 48-year-old male suffered from a relapsing bilateral ON. At first presentation, BCVA was 0.1 in the right eye and finger counting in the left eye. BCVA fully recovered after each pulse therapy with intravenous methylprednisolone (two cycles). Since the first relapse, the patient has been receiving long-term immunosuppression with rituximab. Despite rituximab and low-dose oral prednisone, the patient had another relapse with a left ON. After a third cycle with intravenous methylprednisolone, he partially recovered. BCVA at last follow-up was 1.0 in the right and 0.8 in the left eye. Conclusions MOG-IgG antibodies have been identified in different acquired demyelinating syndromes. The patients reported had an ADEM followed by bilateral ON, an isolated bilateral ON, and a relapsing bilateral ON. Individual treatment strategies led to substantial visual recovery in all patients. We recommend inclusion of MOG-IgG antibodies in the diagnostic workup at least after the first recurrence of ON since they can serve as a diagnostic and potential prognostic tool and might lead to specific therapeutic recommendations.

Optical Coherence Tomography Angiography Features of Intrachoroidal Peripapillary Cavitation

2017 ◽  
Vol 27 (2) ◽  
pp. e32-e34 ◽  
Author(s):  
Andrea Mazzaferro ◽  
Adriano Carnevali ◽  
Ilaria Zucchiatti ◽  
Lea Querques ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Inferior Border ◽  
The Right

Purpose To evaluate the optical coherence tomography angiography (OCT-A) features of a peripapillary intrachoroidal cavitation (ICC) in a patient with high myopia. Methods A 67-year-old woman with ICC underwent visual acuity testing, refraction, slit-lamp biomicroscopy, dilated fundus examination, and OCT-A. The main findings are described in this case report. Results Best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed in the right eye a macular scar, a tilted disc along with a peripapillary staphyloma, and an orange-yellowish lesion on the inferior border of the disc. Structural OCT B-scan showed ICC as an intrachoroidal hyporeflective space located below the normal plane of the retinal pigment epithelium adjacent to the optic nerve head. Optical coherence tomography angiography showed the cavitation as a hyporeflective area, devoid of detectable flow from the choriocapillaris and large choroidal vessels layers, suggesting the choroid, including the residual hyperreflective tissue in the outer aspect of the retinal pigment epithelium/Bruch membrane, to be avascular in ICC. Conclusions Optical coherence tomography angiography demonstrated the absence of choroidal and choriocapillary network.

scholarly journals Bevacizumab for Macular Serous Neuroretinal Detachment in Tilted Disk Syndrome

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Paolo Milani ◽  
Alfredo Pece ◽  
Luisa Pierro ◽  
Patrizio Seidenari ◽  
Paolo Radice ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Monthly Interval ◽  
Serous Macular Detachment ◽  
Corrected Visual Acuity ◽  
Total Observation ◽  
Tilted Disk ◽  
Best Corrected Visual Acuity

Background. Tilted disc syndrome (TDS) is a congenital anomaly characterized by “tilting” of the optic disc tipycally associated with myopic astigmatism, visual field defect, inferior staphyloma, and retinal pigment epithelium atrophy. Associated complications such as macular serous neuroretinal detachment are well described; however, ideal therapy for such complication is unknown.Methods. One interventional case report is hereby described. A patient affected by macular serous neuroretinal detachment-complicated tilted disk syndrome underwent a complete ophthalmic examination. Optical coherence tomography and fluorescein angiography were taken at baseline and at scheduled visits. Two intravitreal treatments of bevacizumab (avastin, 1.25 mg/0.05 mL) were performed at monthly interval.Results. At scheduled visit, one month after the second injection, OCT depicted persistence of neuroretinal detachment. Best-corrected visual acuity remain stable as well as metamorphopsia and functional discomfort.Conclusion. Clinical evidence of this brief interventional case report indicates that one patient affected by recent serous macular detachment-complicated TDS did not benefit from 2 consecutive monthly intravitreal Avastin treatments. Best-corrected visual acuity remained stable over a total observation period of 6 months.

Multimodal imaging in iodate-induced toxic retinopathy

2020 ◽  
pp. 112067212092686
Author(s):  
Sebile Çomçalı ◽  
Pınar Topcu Yılmaz ◽  
Cemal Çavdarlı ◽  
Mehmet Numan Alp
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Iodine Deficiency ◽  
Vision Loss ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Vitamin Supplementation ◽  
Potassium Iodate ◽  
Intentional Ingestion ◽  
The Right

Introduction Iodine deficiency is a leading cause of preventable physical and mental retardation. Potassium iodate is used for iodine supplementation to prevent iodine deficiency. We herein report a case of toxic retinopathy following intentional ingestion of potassium iodine. Case Presentation A 41-year-old male presented with a 5-day history of blurred vision in both eyes. His visual acuity (VA) was hand motion and his pupillary reactions were sluggish bilaterally. The fundus examination revealed bilaterally diffuse retinal pigment epithelium atrophy and secondary pigmentary changes at the posterior pole, but his peripheral fundus was relatively spared. Choroidal thinning, punctate hyperreflective dots along the retinal pigment epithelium layer, and outer retinal atrophy were the optical coherence tomography findings, which were consistent with widespread areas of retinal pigment epithelium window defects observed on fundus fluorescein angiography. The visual evoked potential test showed no response in the right eye and revealed a delay in the latency and a decrease in the amplitude of the P100 wave in the left eye. Wave b responses of the photoreceptors could not be observed in the patient’s electroretinogram. After a vitamin supplementation protocol consistent with the literature, at the 4-month follow-up visit his visual acuity had improved to 0.3 in the right eye and counting fingers in the left eye. Conclusion Potassium iodate toxicity is a cause of serious retinal and choroidal damage and results in severe vision loss. Hydration, hemodialysis, and antioxidants can be helpful to minimize the complications.

scholarly journals Ocular findings among patients surviving COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ílen Ferreira Costa ◽  
Livia Pimenta Bonifácio ◽  
Fernando Bellissimo-Rodrigues ◽  
Eduardo Melani Rocha ◽  
Rodrigo Jorge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pigment Epithelium ◽  
Demographic Data ◽  
Retinal Pigment ◽  
Anterior Segment ◽  
Posterior Pole ◽  
Architecture Evaluation ◽  
Severe Group ◽  
The Mean ◽  
The Right

AbstractTo describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

scholarly journals DMEK IN KERATOCONUS WITH ACUTE HYDROPS: A CASE REPORT

2018 ◽  
Vol 17 (3) ◽  
pp. 81
Author(s):  
Lucio V L Maranhão ◽  
Paulo E C Dantas ◽  
Natalia R L Ramalho ◽  
Wanessa P Pinto
Keyword(s):  
Visual Acuity ◽  
Corneal Edema ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Hand Motion ◽  
Severe Visual Loss ◽  
Corrected Visual Acuity ◽  
Corneal Hydrops ◽  
The Right ◽  
Initial Results ◽  
Best Corrected Visual Acuity

We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft.  

scholarly journals Pachymeningitis in a Patient With Granulomatosis With Polyangiitis; A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 80-82
Author(s):  
Gholam Hossein Alishiri ◽  
Ehsan Rahmanian ◽  
Mahsa Ramezanpour
Keyword(s):  
Visual Acuity ◽  
Granulomatosis With Polyangiitis ◽  
Rare Complication ◽  
Brain Mri ◽  
Blurred Vision ◽  
Orbital Mass ◽  
Autoimmune Antibodies ◽  
Finger Counting ◽  
Nerve Paresis ◽  
The Right

Introduction: Granulomatosis with polyangiitis (GPA) is a systematic and necrotizing vasculitis with positive autoimmune antibodies. Some studies have reported the prevalence of eye involvement between 40%-50% of cases. Retro orbital granuloma is a rare complication of GPA which should be treated by surgical involvements, while pachymeningitis can be diagnosed by MRI and treated by medical management. In this study, we tried to present a case of GPA with optic neuritis and typical central nervous system (CNS) involvement, while there were no definite features of sinusitis or kidney injuries. Case Presentation: A 15-year-old girl was admitted because of blurred vision in her left eye. She was a known case of GPA three years ago with initial features, including left facial nerve paresis due to pan-sinusitis and pulmonary cavity. Neurologic evaluations, including sensory and motor features, were normal, too. Ophthalmologic examinations showed that visual acuity of the right eye was good, while the visual acuity in the left eye decreased to the point of finger counting at a distance of 20 cm. The left eye Marcus gunn test was positive (3+); anterior and posterior eye segments were normal. The patient was evaluated by brain MRI with gadolinium and a pathologic enhancement in the left cavernous was seen which had a pressure effect on the optic nerve. She was treated by intravenous methylprednisolone followed by rituximab. Conclusion: Reporting orbital mass in a patient who had GPA can be supposed as granuloma which needs a biopsy to confirm a diagnosis. In our case, the imaging manifestation was heterodox for granuloma, while neurosurgical consultation recommended drug treatment for pachymeningitis.

scholarly journals Sign of the unilateral “Coca-Cola Bottle”: in addition to thyroid disease

2021 ◽  
Author(s):  
Igor Oliveira da Fonseca ◽  
Stella de Angelis Trivellato ◽  
Mayara Apolinario Januzzi ◽  
Guilherme Drumond Jardini Anastacio ◽  
Igor de Lima e Teixeira
Keyword(s):  
Visual Acuity ◽  
Magnetic Resonance ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Graves Disease ◽  
Muscle Involvement ◽  
Characteristic Appearance ◽  
Meningeal Involvement ◽  
The Right ◽  
Classic Sign

Background: The “Coca-Cola Bottle Sign” is a classic sign of thyroid diseases, especially Graves’ disease, with the appearance of eye orbit muscles edema seen by Magnetic Resonance Imaging. The belly of the muscle increases in thickness, giving the characteristic appearance. Despite being classically associated with this etiology, the finding may be present in other diseases, especially infiltrative ones. Objectives: To demonstrate how this radiological signal can suggest other etiologies, when atypical. Methods: Case report of a patient with an image finding suggestive of “CocaCola Bottle Sign”. Results: Patient, 71 years old, with Breast Cancer and Hepatic Metastasis, using Anastrazole. Osmophobia started and after 3 months, reduced visual acuity in the right eye, evolving in 20 days to amaurosis in the right eye, dizzying, and loss of visual acuity in the left eye. Upon examination, he had a missing direct pupillary reflex in the right eye and only light perception, and counting fingers in the left eye; paresis of the Superior Rectus, Medial, and Lower Oblique muscles of the Left Eye, with paresis maintained in the forced duction test. On ophthalmoscopy, he had atrophy of the retinal pigment epithelium in the bilateral periphery, without Papilledema. Metabolic screening did not show any relevant changes. In the Magnetic Resonance of Orbits, an intraconal nodular image was seen in the right orbital cavity, with perineuritis and extension to the belly of the lateral rectus muscle on this side, as the “Coca-Cola Bottle Sign”. Due to unilateral muscle involvement and signs of meningeal involvement, lumbar puncture with cytopathological examination was requested, being positive for Carcinoma Metastasis. Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, however, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation.

Okuläre Symptome nach COVID-19-Infektion

2021 ◽  
pp. 1-3
Author(s):  
Katja Göbel
Keyword(s):  
Visual Acuity ◽  
Pigment Epithelium ◽  
Demographic Data ◽  
Retinal Pigment ◽  
Anterior Segment ◽  
Posterior Pole ◽  
Architecture Evaluation ◽  
Severe Group ◽  
The Mean ◽  
The Right

To describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

Sign in / Sign up

Export Citation Format

Share Document