scholarly journals Ocular Toxoplasmosis Associated with Unilateral Pigmentary Retinopathy That May Mimic Retinitis Pigmentosa: Diagnostic Dilemmas

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 892
Author(s):  
Izabella Karska-Basta ◽  
Bożena Romanowska-Dixon ◽  
Dorota Pojda-Wilczek ◽  
Natalia Mackiewicz
Keyword(s):  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Multifocal Electroretinogram ◽  
Young Male ◽  
Inflammatory Lesion ◽  
Ocular Toxoplasmosis ◽  
Pigmentary Retinopathy ◽  
Polymerase Chain ◽  
The Right ◽  
Chorioretinal Scar

We report a unique case of coexisting pigmentary retinopathy and ocular toxoplasmosis in a young male patient. A 23-year-old man presented with sudden visual deterioration in the left eye (LE). The fundus findings revealed bone spicule-shaped pigment deposits, a slightly pale optic disc, arteriole constriction, cystoid macular edema with an epiretinal membrane, and two small inflammatory chorioretinal scars in the right eye, with a concentric narrowing of the visual field and a nonrecordable multifocal electroretinogram (ERG). An active inflammatory lesion at the border of a pre-existing chorioretinal scar in the macula was found in the LE, with a central scotoma in the visual field. Moreover, the patient tested positive for anti-Toxoplasma gondii immunoglobulin G antibodies and showed positive results in polymerase chain reaction testing of aqueous humor. Fluorescein angiography revealed hyperfluorescence in the early phase with fluorescein leakage. A multifocal ERG of the LE showed selective loss of responses from the central 10 degrees. Genetic testing revealed heterozygosity in the RP1 and CELSR1 genes. Our case illustrates challenges in the diagnosis of unilateral pigmentary retinopathy. Based on the typical toxoplasmic lesions in the LE and two scars likely caused by inflammation, our patient was diagnosed with pigmentary retinopathy probably related to toxoplasmosis. Genetic consultation did not confirm the diagnosis of retinitis pigmentosa, but more advanced tests might be needed to definitively exclude it.

scholarly journals Optic Disc Pit with Sectorial Retinitis Pigmentosa

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Melike Balikoglu-Yilmaz ◽  
Muhittin Taskapili ◽  
Tolga Yilmaz ◽  
Mehmet Yasin Teke
Keyword(s):  
Retinitis Pigmentosa ◽  
Optic Disc ◽  
Fundus Autofluorescence ◽  
Multifocal Electroretinogram ◽  
Clinical Findings ◽  
Optic Disc Pit ◽  
Visual Potential ◽  
History Of ◽  
The Right ◽  
Clinical Conditions

Sectorial retinitis pigmentosa (RP) and optic disc pit (ODP) are rare clinical conditions. We present a 40-year-old woman with a history of mild night blindness and decreased vision in the right eye for about 5 years. Fundus examination revealed retinal pigmentary changes in the superior and inferotemporal sectors covering the macula and reduced arterial calibre and ODP at the temporal edge of the optic disc. In addition, fundus autofluorescence, spectral-domain optical coherence tomography, fluorescein angiography, and multifocal electroretinogram scans confirmed these clinical findings. Visual acuity was decreased due to an atrophic-appearing foveal lesion. No intervention was suggested because of the poor visual potential. To the best of our knowledge, the present study is the first to describe coexistent optic disc pit and sectorial RP in the superior and inferotemporal sectors covering the macula in the same eye with figures.

scholarly journals A Rare Case of Unilateral Retinitis Pigmentosa

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Syntia Nusanti ◽  
Mohamad Sidik ◽  
Ari Djatikusumo ◽  
Elyas Aditya
Keyword(s):  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Clinical Examination ◽  
Rare Case ◽  
Retinal Pigment ◽  
Multifocal Electroretinogram ◽  
Ophthalmological Examination ◽  
Secondary Causes ◽  
Rule Out

Introduction: Retinitis pigmentosa (RP) is a hereditary disorder that diffusely involve photoreceptor and retinal pigment epithelial (RPE). It is characterized by progressive visual field loss and abnormal ERG. Unilateral RP is a rare condition that is usually sporadic. Clinical presentation and ancillary test results are similar to bilateral RP, with only one eye affected. In making the diagnosis of unilateral RP, clinicians must be able to rule out secondary causes, document a normal ERG in the unaffected eye, and follow-up the patient for at least 5 years to rule out bilateral but asymmetric disease. the aim of this case report is how to diagnose a rare case unilateral RP from clinical examination and ancillary tests. Methods: We report a case of a 33-year-old female with slowly progressive restriction of visual field of the left eye in the last one year before admission. Ophthalmological examination of the left eye revealed bone spicules spreading to peripheral fundus. Visual field examination revealed severely constricted visual field of the left eye. The multifocal electroretinogram (mfERG) examination showed severely depressed ERG function with reduced foveal responses. The fellow eye was within normal limit. Results: Patient was diagnosed with unilateral RP and must be followed-up for at least five years to rule out bilateral yet asymmetric disease. Making diagnosis of unilateral RP become one of the challenging case. Clinicians must be able to rule out the secondary causes that also have unilateral pigmentary retinal degeneration. Conclusion: With a good clinical examination and some simple ancillary tests, we could correctly diagnose unilateral RP. However, in this case we still need five years follow up to rule out bilateral RP yet asymmetric disease.

Visual asymmetries during face encoding Increased dwell time and fixations in the upper and left hemifields

2018 ◽  
Author(s):  
Fatima Maria Felisberti
Keyword(s):  
Face Recognition ◽  
Eye Movements ◽  
Visual Field ◽  
Face Processing ◽  
Dwell Time ◽  
The Other ◽  
Environmental Cues ◽  
Reading Habits ◽  
The Right

Visual field asymmetries (VFA) in the encoding of groups rather than individual faces has been rarely investigated. Here, eye movements (dwell time (DT) and fixations (Fix)) were recorded during the encoding of three groups of four faces tagged with cheating, cooperative, or neutral behaviours. Faces in each of the three groups were placed in the upper left (UL), upper right (UR), lower left (LL), or lower right (LR) quadrants. Face recognition was equally high in the three groups. In contrast, the proportion of DT and Fix were higher for faces in the left than the right hemifield and in the upper rather than the lower hemifield. The overall time spent looking at the UL was higher than in the other quadrants. The findings are relevant to the understanding of VFA in face processing, especially groups of faces, and might be linked to environmental cues and/or reading habits.

scholarly journals Proning related bilateral anterior ischaemic optic neuropathy in a patient with COVID-19 related acute respiratory distress syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsty Michelle Clarke ◽  
Vivi Riga ◽  
Amy-lee Shirodkar ◽  
Joel Meyer
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Visual Field ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Vision Loss ◽  
Prone Positioning ◽  
Disc Oedema ◽  
Ischaemic Optic Neuropathy ◽  
The Right

Abstract Background Non-arteritic ischaemic optic neuropathy (NAION) is a rare but harmful complication of prone positioning. Prone mechanical ventilation is a therapeutic strategy which has been used extensively during the COVID-19 pandemic to treat acutely hypoxemic patients with COVID-19 related acute respiratory distress syndrome (ARDS). Though a small number of cases of unilateral NAION have been reported in patients testing positive for the SARS-CoV-2 virus, we describe what is to our knowledge, the first reported case of bilateral NAION occurring in a patient proned extensively for the treatment of COVID-19 related ARDS. We consider the potential aetiological factors leading to NAION after prone mechanical ventilation in patients with COVID-19 and suggest strategies to protect against its development. Case presentation : We report a case of severe, irreversible, visual impairment secondary to bilateral anterior ION in a fifty-five-year-old male who underwent eight episodes of prone mechanical ventilation to treat COVID-19 related ARDS. Once weaned from his sedation he reported bilateral painless vision loss, and bedside ophthalmological assessment identified a reduced visual acuity of 3/30 unaided in the left eye and counting fingers in the right. Dilated indirect ophthalmoscopy revealed inferotemporal optic disc oedema with splinter haemorrhages in the right eye and mild disc oedema, temporal pallor, and nerve fibre layer haemorrhages inferiorly in the left eye. Humphrey visual field 24 − 2 testing confirmed a severely constricted visual field with macular sparing on the right and depressed inferonasal vision with preserved peripheral vision on the left eye. OCT disc imaging shortly after diagnosis revealed bilateral disc swelling and flame haemorrhages in the right eye. Conclusions NAION is a devastating, but preventable complication of prone positioning, which may pose significant risk of vision loss in patients with COVID-19 related ARDS.

scholarly journals Clinical Phenotype of PDE6B-Associated Retinitis Pigmentosa

2021 ◽  
Vol 22 (5) ◽  
pp. 2374
Author(s):  
Laura Kuehlewein ◽  
Ditta Zobor ◽  
Katarina Stingl ◽  
Melanie Kempf ◽  
Fadi Nasser ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Genetic Testing ◽  
Retinitis Pigmentosa ◽  
Fundus Autofluorescence ◽  
Retinal Disease ◽  
New Drugs ◽  
Autofluorescence Imaging ◽  
Full Field ◽  
Tertiary Referral Center ◽  
The Right

In this retrospective, longitudinal, observational cohort study, we investigated the phenotypic and genotypic features of retinitis pigmentosa associated with variants in the PDE6B gene. Patients underwent clinical examination and genetic testing at a single tertiary referral center, including best-corrected visual acuity (BCVA), kinetic visual field (VF), full-field electroretinography, full-field stimulus threshold, spectral domain optical coherence tomography, and fundus autofluorescence imaging. The genetic testing comprised candidate gene sequencing, inherited retinal disease gene panel sequencing, whole-genome sequencing, and testing for familial variants by Sanger sequencing. Twenty-four patients with mutations in PDE6B from 21 families were included in the study (mean age at the first visit: 32.1 ± 13.5 years). The majority of variants were putative splicing defects (8/23) and missense (7/23) mutations. Seventy-nine percent (38/48) of eyes had no visual acuity impairment at the first visit. Visual acuity impairment was mild in 4% (2/48), moderate in 13% (6/48), and severe in 4% (2/48). BCVA was symmetrical in the right and left eyes. The kinetic VF measurements were highly symmetrical in the right and left eyes, as was the horizontal ellipsoid zone (EZ) width. Regarding the genetic findings, 43% of the PDE6B variants found in our patients were novel. Thus, this study contributed substantially to the PDE6B mutation spectrum. The visual acuity impairment was mild in 83% of eyes, providing a window of opportunity for investigational new drugs. The EZ width was reduced in all patients and was highly symmetric between the eyes, making it a promising outcome measure. We expect these findings to have implications on the design of future PDE6B-related retinitis pigmentosa (RP) clinical trials.

scholarly journals Compartment Syndrome: an Acute Femoral Stress Fracture in a Young Male Athlete

2021 ◽  
Author(s):  
Amelie Kanovsky ◽  
Ernst J. Mueller
Keyword(s):  
Compartment Syndrome ◽  
Muscle Mass ◽  
Stress Fracture ◽  
Acute Stress ◽  
Young Male ◽  
Young Males ◽  
Fatigued Muscle ◽  
Fracture Osteosynthesis ◽  
Initial Fracture ◽  
The Right

AbstractThe incidence of an acute compartment syndrome (ACS) of the thigh is less than 1%. It is most common in the setting of muscle overuse or muscle injury, as well as secondary to trauma, such as a femoral fracture. We present a case of an ACS in a young, healthy, and semiprofessional athlete with normal coagulation who sustained an acute stress fracture of the distal femur. After the initial fracture osteosynthesis, the patient suffered from a compartment syndrome in the right anterior aspect of the distal thigh. Following rapid surgical fasciotomy, the case was uneventful, and he returned to his preinjury sport level without any neurological consequences. This case confirms that ACS in the thigh is rare, but mainly occurs in young males with a large muscle mass due to participation in various athletic programs. We hypothesize that constant muscle over-usage primes for a larger amount of contused and protruding muscle mass in the small femoral compartment. Hence, the fatigued muscle subjects the bone to an increased mechanical force resulting in an overloading process. This ensues the accumulation of femoral microfractures and primes for the occurrence of an increased rate of stress fractures and an ACS in the thigh.

scholarly journals Aortic Valve Endocarditis with Anomalous Origin of the Right Coronary Artery and Unknown Infected Thrombus in the Dissected Descending Thoracic Aorta

Aorta ◽  
2020 ◽  
Vol 08 (03) ◽  
pp. 076-079
Author(s):  
Juan Caceres ◽  
Vikram Sood ◽  
Linda Farhat ◽  
Bo Yang
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Aortic Root ◽  
Recurrent Infection ◽  
Young Male ◽  
Descending Thoracic Aorta ◽  
Native Valve ◽  
Aggressive Approach ◽  
Aortic Thrombus ◽  
The Right

AbstractWe report an intricate aortic root replacement in a young male patient suffering from native valve infective endocarditis due to Serratia marcescens. Further complicating the total root replacement, there was an unknown infected aortic thrombus and a concomitant anomalous right coronary artery with an intramural course. As a result of our more aggressive approach, we believe that we lowered the risk of recurrent infection of the bioprosthesis of the aortic root.

scholarly journals Lateralization of attention in adults with ADHD: Evidence of pseudoneglect

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Bartosz Helfer ◽  
Stefanos Maltezos ◽  
Elizabeth Liddle ◽  
Jonna Kuntsi ◽  
Philip Asherson
Keyword(s):  
Reaction Time ◽  
Visual Field ◽  
Reaction Times ◽  
Study Participant ◽  
Reaction Time Task ◽  
Right Visual Field ◽  
Time Variability ◽  
Incentive Condition ◽  
Reaction Time Variability ◽  
The Right

Abstract Background. We investigated whether adults with attention-deficit/hyperactivity disorder (ADHD) show pseudoneglect—preferential allocation of attention to the left visual field (LVF) and a resulting slowing of mean reaction times (MRTs) in the right visual field (RVF), characteristic of neurotypical (NT) individuals —and whether lateralization of attention is modulated by presentation speed and incentives. Method. Fast Task, a four-choice reaction-time task where stimuli were presented in LVF or RVF, was used to investigate differences in MRT and reaction time variability (RTV) in adults with ADHD (n = 43) and NT adults (n = 46) between a slow/no-incentive and fast/incentive condition. In the lateralization analyses, pseudoneglect was assessed based on MRT, which was calculated separately for the LVF and RVF for each condition and each study participant. Results. Adults with ADHD had overall slower MRT and increased RTV relative to NT. MRT and RTV improved under the fast/incentive condition. Both groups showed RVF-slowing with no between-group or between-conditions differences in RVF-slowing. Conclusion. Adults with ADHD exhibited pseudoneglect, a NT pattern of lateralization of attention, which was not attenuated by presentation speed and incentives.

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