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 Ischaemic stroke and pre-eclampsia in the third trimester of pregnancy: a diagnostic and therapeutic challenge

2019 ◽  
Vol 12 (12) ◽  
pp. e229635
Author(s):  
Alexandros Loukas Grammatis ◽  
Hannah Louise Catton ◽  
Derek Hilton
Keyword(s):  
Severe Hypertension ◽  
Fetal Monitoring ◽  
Mass Effect ◽  
Emergency Caesarean Section ◽  
Middle Cerebral Artery Territory ◽  
Good Recovery ◽  
Left Hemiparesis ◽  
Third Trimester ◽  
The Third ◽  
The Right

A 23-year-old low-risk primiparous patient, who was 35 weeks pregnant, presented in the emergency department after collapsing at home. Her observations showed severe hypertension with proteinuria. On examination, she had left hemiparesis and was aphasic. Fetal monitoring was reassuring. Initial CT did not reveal any evidence of intracranial pathology. She was stabilised and delivered via emergency caesarean section. Subsequent MRI and CT showed an acute right-sided infarct involving the right middle cerebral artery territory, frontal and parietal regions, and increased mass effect. She was transferred to the nearest neurosurgical centre where she was conservatively managed and discharged home 3 weeks later for continuing rehabilitation. She achieved a good recovery.

scholarly journals Combined Penetrating Keratoplasty Followed by Pars Plana Vitrectomy for Firecracker Induced Bilateral Corneal and Intraocular Foreign Body: A Case Report

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Lily Rajbanshi ◽  
Archana Kumari ◽  
Sanjay Singh
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Hand Movement ◽  
Intraocular Foreign Body ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Pars Plana ◽  
The Right ◽  
Open Globe Injuries

Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its associationwith the intraocular foreign body makes the diagnosis and treatment even more difficult resultingin poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented withbilateral, multiple corneal and intraocular foreign body due to firecracker explosion. His vision waslimited to hand movement in both eyes. Combined penetrating keratoplasty and cataract surgerywere done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal.The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eyerespectively. The encouraging result in our case prompts ophthalmologists for a timely stepwisemultidisciplinary approach in all open globe injuries with intraocular foreign body cases havingpoor initial acuity.

scholarly journals Cataract following electric shock - Case report

2020 ◽  
Vol 8 (3) ◽  
pp. 167-170
Author(s):  
Simanta Khadka ◽  
Raghunandan Byanju ◽  
Sudha Ranabhat
Keyword(s):  
Visual Acuity ◽  
Electric Shock ◽  
Burn Injury ◽  
Ocular Trauma ◽  
Posterior Chamber ◽  
Ocular Complications ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Posterior Chamber Intraocular Lens ◽  
The Right

Ocular trauma is the under-recognized cause of unilateral blindness particularly in developing nations.The growing demand on generated electricity has also led to increase in electricity related occupational trauma. We report a case of bilateral cataract in a 22 years professional electrician. He survived a high voltage electric shock and sustained burn injury on the right side of his head. Ocular examination revealed typical anterior as well as posterior subcapsular cataract in right eye and visually insignificant early anterior subcapsular vacuoles in the left eye. There was a significant difference in lenticular opacification density in between these two eyes. Uneventful phacoemulsification and foldable posterior chamber intraocular lens implantation was performed in the right eye and the sufferer was rehabilitated with normal best corrected visual acuity. The possibility of ocular complications and importance of ocular screening is emphasized in the survivors of electrical injury. The lenticular opacities can be successfully managed with surgery, however the final visual acuity depends on damage to other vital ocular structures. The clinical features, pathogenic mechanism of these opacities and review of the literatures are discussed.

scholarly journals Bilateral Post-electrocution Cataract

2020 ◽  
Vol 35 (4) ◽  
pp. 302-304
Author(s):  
Anum Javed ◽  
Owais Arshad ◽  
Javeria Nasir ◽  
Mohammad Hanif Chatni
Keyword(s):  
Hand Movement ◽  
Slit Lamp ◽  
Multiple Forms ◽  
Anterior Capsule ◽  
Slit Lamp Examination ◽  
Corrected Visual Acuity ◽  
Life Threatening ◽  
Electric Injury ◽  
The Right ◽  
Fundoscopic Examination

Trauma from electric injury can be of multiple forms, ranging from mild damage to life-threatening conditions like cardiac arrest. Ophthalmic injuries are not uncommon following electrocution. We report a case of post electrocution cataract in a 24 year old male who presented to us three years after the injury. On examination his best corrected visual acuity was 1/60 in the right eye and hand movement in the left eye. Slit lamp examination revealed a white, mature cataract in the left eye and a developing anterior capsular cataract in the right eye. B-scan of left eye was normal. Fundoscopic examination of right eye was normal. Left cataract surgery was done. Per-operatively, the capsulorhexis was surgically challenging due to the adherence of the cataract with the anterior capsule. The BCVA in the left eye was 6/6 postoperatively.   MeSh Words : Electric Injury Cataract, Phacoemulsification, Capsulorhexis

scholarly journals Spontaneous Rupture of Uterine Vein in Twin Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Emek Doger ◽  
Yigit Cakiroglu ◽  
Sule Yildirim Kopuk ◽  
Bertan Akar ◽  
Eray Caliskan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Laboratory Tests ◽  
Twin Pregnancy ◽  
Acute Abdominal Pain ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Hypovolemic Shock ◽  
Third Trimester ◽  
The Right

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester.Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear.Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

scholarly journals Capsular Bag Distension Syndrome Following Phacoemulsification with Implantation of Intraocular Lens

2020 ◽  
Vol 15 (2) ◽  
pp. 306-312
Author(s):  
Safinaz Mohd Khialdin ◽  
Keyword(s):  
Intraocular Lens ◽  
Rare Complication ◽  
Posterior Chamber ◽  
Poor Vision ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens ◽  
The Right ◽  
Capsular Bag

Capsular bag distension syndrome is a rare complication following phacoemulsification with posterior chamber intraocular lens implantation. We describe the case of a middle-age male, who developed early onset capsular bag distension syndrome of the right eye after phacoemulsification with implantation of plate haptic posterior chamber intraocular lens (Zeiss CT ASPHINA 509MP). There was persistent poor vision during follow up at 1 week and 5 weeks post-surgery with a myopic shift of 2.5 diopters sphere (DS). The intraocular pressure was only elevated at 2 hours post-operative and was normal during the subsequent followup. Distension of capsular bag was confirmed with the IOP Master 700 which showed abnormal separation of posterior capsule from the intraocular lens. He was diagnosed with capsular bag distension syndrome secondary to retention of viscoelastic. Right eye removal of retained viscoelastic was performed and the capsular bag distension syndrome resolved successfully with best corrected visual acuity at 6/6. Hence, complete clearance of viscoelastic during phacoemulsification with plate haptic intraocular lens is important in order to prevent capsular bag distension syndrome.

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.  

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 The clinical spectrum of ocular bartonellosis: a retrospective study at a tertiary centre in Malaysia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Michele Shi-Ying Tey ◽  
Gayathri Govindasamy ◽  
Francesca Martina Vendargon
Keyword(s):  
Hand Movement ◽  
Clinical Findings ◽  
Common Finding ◽  
Final Visit ◽  
Ocular Involvement ◽  
Exudative Retinal Detachment ◽  
Tertiary Centre ◽  
Ocular Manifestations ◽  
Ocular Findings ◽  
Clinical Records

Abstract Background Cat scratch disease (CSD) is a systemic illness caused by the gram-negative bacillus, Bartonella henselea, which can occasionally involve the ocular structures. The objective of this study is to evaluate the various clinical presentations of ocular bartonellosis at our institution. A retrospective review of the clinical records of 13 patients (23 eyes) with ocular manifestations of Bartonella infections over a 3-year period between January 2016 to December 2018 was undertaken at our institution. Results The diagnosis was made based on clinical findings and in addition, with the support of the evidence of Bartonella hensalae IgG and/or IgM. Small retinal white lesions were the most common ocular findings in this series of patients (82.6% of eyes, 76.9% of patients). Neuroretinitis was the second most common finding (47.8% of eyes, 69.2% of patients), followed by exudative retinal detachment involving the macula (34.8% of eyes, 53.8% of patients) and Parinaud’s oculoglandular syndrome (17.4% of eyes, 23.1% of patients). Other findings like isolated optic disc oedema without macular star (8.7% of eyes, 15.4% of patients) and vitritis (4.3% of eyes, 7.7% of patients) were also observed. Ten patients (76.9%) had bilateral ocular involvement. Most of the patients were young, immunocompetent and had systemic symptoms like fever prior to their ocular symptoms. The visual acuity (VA) at initial presentation ranged from 6/6 to hand movement (mean, 6/20), and at final visit 6/6 to 6/60, (mean, 6/9). 91.7% of patients were treated with antibiotics. Only 2 patients received oral corticosteroids together with antibiotics due to very poor vision on presentation. The visual prognosis of ocular bartonellosis is generally good with 16 (88.9%) of 23 eyes having VA of 6/12 or better at final follow-up visit. Conclusion Small foci of retinal white lesions were the most common manifestation of ocular bartonellosis in this series, followed by neuroretinitis, though an array of other ocular findings may also occur. Therefore, we should consider bartonella infection as a possible differential diagnosis in those patients.

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

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