scholarly journals Leukostatic retinopathy: a sight-threatening complication of chronic myeloid leukaemia with severe hyperleukocytosis

2020 ◽  
Vol 1 (4) ◽  
pp. 289-294
Author(s):  
Chuan Chun Lim ◽  
Norlina Mohd Ramli
Keyword(s):  
Childhood Leukemia ◽  
Silicone Oil ◽  
Rare Complication ◽  
Hand Movement ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Hypertensive Retinopathy ◽  
Poor Visual Outcome ◽  
Cotton Wool Spots ◽  
The Right

Retinopathy secondary to chronic myeloid leukemia (CML) commonly manifests as venous dilation and tortuosity, retinal hemorrhages, microaneurysms, and cotton-wool spots which are similar to features of non-proliferative diabetic retinopathy or hypertensive retinopathy. However, massive vitreous hemorrhage is rarely encountered, especially among those treated with chemotherapy. We report a case of a young CML patient in accelerated phase, presenting with bilateral painless sudden visual loss. Fundus examination showed bilateral dense vitreous hemorrhage. Laboratory results showed thrombocytopenia with a very low platelet count. Magnetic resonance imaging (MRI) of the brain and orbit showed subacute intraparenchymal hemorrhages and bilateral intraocular hemorrhages. We performed pars plana vitrectomy (PPV) and endolaser on the left eye, which had more extensive vitreous hemorrhage. At one-week follow-up, the patient unfortunately developed a retinal detachment. The patient underwent a second PPV with endolaser and insertion of silicone oil. Despite the prompt surgical intervention, the patient developed an ischemic retina resulting in poor visual prognosis. One month later, we performed PPV and endolaser on the right eye. Postoperatively, her vision improved significantly from hand movement to pinhole vision 6/45. Dense vitreous hemorrhage is a rare complication of childhood leukemia. General physicians should refer leukemic patients for ophthalmic evaluation. Awareness of potentially blinding complications of CML and prompt referral upon diagnosis is warranted for early detection and treatment. Reduced awareness of this potentially blinding complication may result in poor visual outcome.  

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

scholarly journals Lens induced glaucoma: An experience in tertiary eye care center in eastern Nepal

2017 ◽  
Vol 8 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Rakshya Pant Sitoula ◽  
Indrajit Sarkar ◽  
Devdutta Nayak ◽  
Sanjay Kumar Singh
Keyword(s):  
Cataract Surgery ◽  
Care Center ◽  
Hand Movement ◽  
Case Series ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Late Presentation ◽  
Delayed Presentation ◽  
Poor Visual Outcome ◽  
Prospective Case Series

Introduction: Lens Induced Glaucoma (LIG), is one of commonest cause of secondary glaucoma due to senile cataracts. The purpose of this study was to see the outcome of cataract surgery in patients with LIG. Methods: This was a prospective case series of 40 patients with LIG who presented to our hospital between April to June 2014. The purpose of this study was to look into the age and sex distribution, causes for delayed presentation, immediate post-operative visual outcome and the reasons for poor visual outcome. Result: There were 23 phacomorphic cases and 17 phacolytic glaucoma patients included in our study. The mean age at presentation was 63±10 years. Female to male ratio was 2.1:1. The majority of patients 57% presented after 2 weeks of symptoms and the reason for late presentation in more than half of the patients (52.5%) was financial constraints. At presentation, mean preoperative intra ocular pressure was 39±10 mm Hg. Following surgery, 36 of 40 eyes (90%) had an IOP less than 21 mm Hg at discharge. Visual acuity was either hand-movement or just perception of light in all eyes before surgery. At discharge, 26 of 40 operated eyes (65%) achieved 6/60 or better, 2 (5%) had less than 6/60 and 12 (30%) less than 3/60. The reasons for poor VA in these 12 patients were optic atrophy in 5 patients, uveitis in 5 patients, macular cause in one and corneal edema in one. Conclusion: Cataract surgery proves to be effective in lowering the Intraocular pressure and visual recovery in patients with lens induced glaucoma. 

Intraventricular silicone oil

2013 ◽  
Vol 118 (5) ◽  
pp. 1127-1129 ◽  
Author(s):  
Chih-Chen Chang ◽  
Hong-Shiu Chang ◽  
Cheng Hong Toh
Keyword(s):  
Chemical Shift ◽  
Intraventricular Hemorrhage ◽  
Silicone Oil ◽  
Rare Complication ◽  
Surgical Removal ◽  
Contrast Enhanced ◽  
History Of ◽  
Orbital Content ◽  
The Right ◽  
Mri Study

The authors report a case in which intravitreous silicone oil migrated into the ventricles. They note that intraventricular silicone oil can be misdiagnosed as intraventricular hemorrhage and neurosurgeons should be aware of this possibility. This 58-year-old woman with a history of Type II diabetic mellitus and retinal detachment (resulting from diabetic retinopathy), which had been treated with intravitreous silicone tamponade, presented with dizziness and headache approximately 10 years after the intravitreous silicone treatment. Over the next 6 years she underwent 2 non–contrast-enhanced brain CT studies and 1 MRI study for evaluation of her symptoms. On CT scan, extension of the intraocular silicone along the optic nerve was evident. Two hyperdense nodules were observed freely floating in the right lateral and fourth ventricles, remaining in the nondependent portion of ventricles in both supine and prone positions. On T2-weighted MRI, the left orbital content and the intraventricular nodules all demonstrated chemical shift artifacts typically associated with silicone. The imaging findings were characteristic for intraventricular silicone after silicone oil tamponade. The patient's dizziness and headache were treated symptomatically and she was followed up at the outpatient department. Migration of intravitreous silicone oil into the cerebral ventricles is a rare complication. Intraventricular silicone oil can mimic intraventricular hemorrhage. Radiographically, intraventricular silicone oil can be distinguished from hemorrhage as silicone oil tends to stay in the nondependent portion of the ventricle. Chemical shift artifacts on MRI may help establishing the diagnosis of intraventricular silicone oil. Currently, there is no consensus on surgical removal of intraventricular silicone oil, and in the majority of cases reported in the literature, the patients were asymptomatic.

scholarly journals Ocular complications in pre-eclampsia

2020 ◽  
Vol 2 (1) ◽  
pp. 55-61
Author(s):  
Dian Nadia Abu Talib ◽  
Wahidah Wagimon ◽  
Ainal Adlin Naffi ◽  
Rona Asnida Nasaruddin ◽  
Jemaima Che-Hamzah ◽  
...  
Keyword(s):  
Rare Complication ◽  
Hand Movement ◽  
Emergency Caesarean Section ◽  
Exudative Retinal Detachment ◽  
Third Trimester ◽  
Ocular Complications ◽  
Choroidal Circulation ◽  
Corrected Visual Acuity ◽  
Counting Finger ◽  
The Right

Exudative retinal detachment (ERD) is a rare complication of pre-eclampsia in pregnancy. The pathophysiology is uncertain but it is thought to be due to microvasculopathy involving the choroidal circulation. We report a case of a 36-year-old woman with underlying essential hypertension complicated with impending eclampsia in her third trimester of pregnancy. She developed bilateral bullous ERD at 34 weeks of gestation. Following emergency caesarean section, her blood pressure normalised after 10 days and the ERD partially resolved spontaneously after 30 days. Her best-corrected visual acuity improved from hand movement (HM) in the right eye and counting finger (CF) in the left eye to 6/24 bilaterally after 30 days postpartum. Pre-eclampsia-induced ERD is usually managed conservatively and the prognosis is usually good.

scholarly journals Salzmann nodular degeneration after photorefractive keratectomy for hyperopia

2015 ◽  
Vol 14 (2) ◽  
pp. 77-81
Author(s):  
Pawan Prasher
Keyword(s):  
Visual Acuity ◽  
Rare Complication ◽  
Visual Outcome ◽  
Early Postoperative Period ◽  
Photorefractive Keratectomy ◽  
Brown Pigment ◽  
Corneal Surface ◽  
Uncorrected Visual Acuity ◽  
Nodular Lesions ◽  
The Right

Purpose: To report a case of bilateral central Salzmann nodular degeneration (SND) after photorefractive keratectomy (PRK) for hyperopia.Methods: Case report.Results: A 47-year-old male presented with complaints of glare and difficulty with night driving. He had undergone PRK for hyperopia (+3.5+1.5x180 in the right eye and +4.5+1.0x180 in the left eye) in both eyes about 15 years back. The early postoperative period was uneventful; however, he started having these symptoms after two to three months. At presentation, uncorrected visual acuity was 20/100 and best corrected visual acuity was 20/30 with +3.5+1.0x180 in both eyes. Slit-lamp examination showed bilateral 1-1.5 mm diameter, bluish white nodular lesions involving the central corneas. There were also prominent paracentral brown pigment ring deposits consistent with pseudo-Fleischer rings in both eyes. Scheimpflug images showed dense hyper-reflective nodules that were associated with elevated anterior corneal surface and measured 290 μm in the right eye and 230 μm in the left eye, along with presence of significant astigmatism (K1- 45.1D, K2- 47.8D right eye and K1- 45.4D, K2- 49.2D left eye). Central pachymetry was 485 μm in the right eye and 464 μm in the left eye.Conclusions: SND is a rare complication of PRK for hyperopia that can lead to suboptimal visual outcome. PRK should be included in the list of etiologies leading to SND.

scholarly journals Long-Term Management of Complications of Retinal Artery Macroaneurysms with Intravitreal Aflibercept Injection

2016 ◽  
Vol 7 (3) ◽  
pp. 440-449 ◽  
Author(s):  
Kamal Kishore
Keyword(s):  
Case Series ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Fundus Photography ◽  
Poor Visual Outcome ◽  
Management Of Complications ◽  
Intravitreal Aflibercept ◽  
Treatment Naïve ◽  
Retinal Artery

Purpose: To report the 1-year follow-up results of intravitreal aflibercept injection (IAI) for the management of complications of retinal artery macroaneurysms (RAM). Methods: A retrospective, noncomparative, interventional case series of 4 eyes of 4 patients (all female, aged 68–91 years, 3 treatment naive) treated with IAI 2 mg for complications of RAM [macular edema (ME) 2, submacular hemorrhage (SMH) 1, and vitreous hemorrhage (VH) 1] was conducted. Baseline parameters consisted of complete ocular examination, medical history, best-corrected Snellen VA, fundus photography, IVFA and SD OCT, unless precluded by VH (1). All patients completed ≥1 year follow-up. Results: Baseline VA was hand motions in the eye with SMH (31 mm2 area and 1,478 μm thickness); 20/40 and 20/100 with ME (CST 390 and 337 μm, respectively), and 20/200 in the eye with VH. At 1 month, both patients with ME showed resolution of ME with CST <300 μm with improvement in VA which was maintained through 1 year. VH resolved in one eye at 1 month with no recurrence after 1 year. The eye with SMH developed macular scar and had counting fingers vision at 1 year. Thrombosis of RAM was noted in all eyes and hairpin-like remodeling of artery in one. No eye required repeat injection or laser. Conclusion: ME and VH from RAM were effectively treated with IAI. However, the eye with thick SMH had poor visual outcome despite thrombosis of RAM. Single IAI provided effective therapy for complications of RAM with excellent anatomical and visual results in each eye, except one with thick SMH, and merits further study.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals THU0597 CORNEAL MELT - DON’T ALWAYS BLAME RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 540.3-540
Author(s):  
A. Munir ◽  
C. Sheehy
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Biopsy ◽  
Systemic Vasculitis ◽  
Lower Lobe ◽  
Visual Outcome ◽  
Eye Drops ◽  
Poor Visual Outcome ◽  
Methyl Prednisolone ◽  
History Of ◽  
And Function

Background:Corneal melt is a rare inflammatory disease of the peripheral cornea; it may lead to perforation of the globe and visual failure. Corneal melt can be a manifestation of systemic vasculitis in patients with RA and other conditions, such as cancer. Without early and aggressive treatment it may be associated with a poor visual outcome and a high mortality. It has been reported in patients with stable RA.Objectives:A case report in a patient with long standing but well controlled Rheumatoid Arthritis (RA) and metastatic disease.Methods:A 75 year old male with a background of sero positive Rheumatoid Arthritis for more than 10 years presented to the Eye Casualty with a two week history of a painful left red eye. His other medical history was significant for Stage IIB poorly differentiated cancer of the left lower lobe. Left lower lobectomy with a patch of diaphragm resected. Intratumoural lymphovascular invasion noted. He completed Adjuvant Carboplatin/Vinorelbine chemotherapy September, 2017. He had DVT proximal left leg 22ndof September, 2017. Follow up CT in 2018 demonstrated a right renal upper pole lesion for which he was awaiting biopsy with?metastatic lung disease vs primary renal carcinoma. His RA was well controlled on Methotrexate 10mg weekly. He had been treated by the ophthalmology team for left marginal Keratitis for the prior 2 months with steroid eye drops without significant improvement. On presentation to ED, he described sharp eye pain, waking him from the sleep, associated with watery discharge and photophobia. Examination showed corneal melt in left eye involving 25% of inferior portion of the cornea and spastic entropion with injecting eye lashes. He had no active joints and there were no other signs of vasculitis. CRP was 4.1. He had a negative ANA and ANCA; viral swabs were negative. He was admitted under the medical team. Intravenous Methyl Prednisolone was started. The patient felt better after 5 days of Methyl Prednisolone. Left temporary tarsorrhaphy was done by Ophthalmology. Cyclophosphamide was initiated after discussion with Oncologist pending the result of the renal biopsy. Patient was discharged after 5 days of admission in the hospitalResults:The renal biopsy was positive for metastatic Squamous cell carcinoma of lung. Cyclophosphamide was withdrawn and he was started on Carboplatin/Gemcitabine. The corneal melt improved with complete resolution of his visual symptoms.Conclusion:In this case, although the history of RA was felt by the ophthalmology team to be the most likely association with the corneal melt, we would argue the oncological diagnoses were likely the driving force behind the presentation.References:[1]Sule A, Balakrishnan C, Gaitonde S, Mittal G, Pathan E, Gokhale NS, et al. Rheumatoid corneal melt. Rheumatology (Oxford)2002;41:705–6.[2]S. Yano, K. Kondo, M. Yamaguchi et al., “Distribution and function of EGFR in human tissue and the effect of EGFR tyrosine kinase inhibition,” Anticancer Research, vol. 23, no. 5, pp. 3639–3650, 2003.Disclosure of Interests:None declared

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

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