Punctate inner choroidopathy complicated with exudative neurosensory detachment: A favorable response to treatment with systemic corticosteroids and intravitreal ranibizumab

2017 ◽  
Vol 92 (7) ◽  
pp. 343-346
Author(s):  
M. Roca ◽  
M. Menezo ◽  
J.M. Ronchera ◽  
J.M. Esteban ◽  
B. Roca
Keyword(s):  
Response To Treatment ◽  
Intravitreal Ranibizumab ◽  
Punctate Inner Choroidopathy ◽  
Systemic Corticosteroids

Case report of osteolytic lesions in a patient with multisystem granulomatous disease

2021 ◽  
Vol 14 (6) ◽  
pp. e242685
Author(s):  
Henco Nel ◽  
Brad Davis ◽  
Brendan Adler ◽  
Eli Gabbay
Keyword(s):  
Cervical Lymphadenopathy ◽  
Granulomatous Inflammation ◽  
Initial Response ◽  
Response To Treatment ◽  
Caucasian Woman ◽  
Granulomatous Disease ◽  
Osteolytic Lesions ◽  
Moderate Growth ◽  
Systemic Corticosteroids ◽  
Lytic Lesions

We present a case of a 70-year-old Caucasian woman with multisystem granulomatous disease involving her lungs, bones and lymph nodes. The patient initially presented with cervical lymphadenopathy and subsequently developed progressive breathlessness. Imaging revealed extensive mediastinal, hilar and intra-abdominal lymphadenopathy as well as bilateral pulmonary parenchymal infiltrates. Lymph node and lung biopsy confirmed non-necrotising granulomatous inflammation while a BAL showed scanty growth of Cryptococcus neoformans and moderate growth of Staphylococcus aureus. The patient received intravenous ceftriaxone and had a good response to treatment. She also completed 3 months of oral fluconazole. Although a diagnosis of sarcoidosis was considered most likely, the patient was not initially started on systemic corticosteroids due to concern around possible infection and initial response to antimicrobials. However, her exercise tolerance gradually deteriorated. A craniofacial CT revealed multiple lytic lesions involving the skull and visualised cervical spine. Biopsy of a clivus lesion revealed non-necrotising granulomatous inflammation while fungal cultures and histopathological stains were negative. The patient was diagnosed with widespread sarcoidosis and she was initiated on prednisolone and methotrexate which led to marked clinical and radiological improvement.

scholarly journals Differentiation between Good and Low-Responders to Intravitreal Ranibizumab for Macular Edema Secondary to Retinal Vein Occlusion

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Marcel N. Menke ◽  
Andreas Ebneter ◽  
Martin S. Zinkernagel ◽  
Sebastian Wolf
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Retinal Thickness ◽  
Response To Treatment ◽  
Intravitreal Ranibizumab ◽  
Phase Versus ◽  
Time Points ◽  
Vein Occlusion ◽  
Low Responders ◽  
Low Responder

Background. Ranibizumab is approved for treatment of macular edema in eyes with retinal vein occlusion (RVO). Some eyes show low-response to treatment with regard to visual acuity gain (VA) and OCT central retinal thickness (CRT) reduction. The goal of this study was to quantify the percentage of low-responders. Methods. Treatment of naïve eyes with macular edema secondary to RVO was included and monthly VA and CRT were analyzed. Four weeks after the loading phase, and at the end of the study, eyes were grouped into low- and good responders based on predefined criteria. The responder and low-responder groups were then compared at various time points. Results. Forty-three eyes were included. Regarding VA, 27.9% were low-responders after the loading phase and 30.2% at the end of the study. For CRT, 34.9% were low-responders after the loading phase versus 27.9% at the end of the study. 75% of patients that were VA low-responders and 73.3% of CRT low-responders after loading phase remained low-responders at the end of the study. Conclusion. Approximately 30% of patients showed low response to ranibizumab after the loading phase and after 1 year of treatment. Two-thirds of patients that were low-responders after the loading phase remained low-responders after 1 year.

scholarly journals Ocular Vogt-Koyanagi-Harada: Is it the era of diagnosis by OCT?

2021 ◽  
Author(s):  
Khaled Elubous ◽  
Mohammed S. Farah ◽  
Ahmed N. Shokry ◽  
Mohammed Abu-Ameereh
Keyword(s):  
Optical Coherence Tomography ◽  
Subretinal Fluid ◽  
Response To Treatment ◽  
Laboratory Evaluation ◽  
Optical Coherence ◽  
Cystic Fluid ◽  
Ocular Symptoms ◽  
Systemic Corticosteroids ◽  
Ophthalmologic Examination ◽  
Fluid Collections

Abstract PURPOSE to report optical coherence tomography (OCT) changes of the retina during acute and recovery phases in a patient with atypical Vogt-Koyanagi-Harada (VKH) disease presented for the first time with ocular symptoms and role of (OCT) in the diagnosis, following and assessing response to treatment.Methods Ophthalmologic examination, laboratory evaluation, fluorescein angiography, and spectral-domain optical coherence tomography performed on a twenty-four-year-old female presented with a bilateral blurring of vision of 3 days.ResultsOCT disclosed multifocal subretinal lobulated cystic fluid collections with thickening and hyper-reflectance in outer retinal layers. Decreased retinal thickness and resolving subretinal fluid collections were seen after commencing treatment by systemic corticosteroids. Conclusion OCT is a very sensitive tool to diagnose and monitor the highly detailed retinal changes during the VKH course especially if presented primarily with ocular symptoms

scholarly journals Effectiveness of Intravitreal Ranibizumab in Nonvitrectomized and Vitrectomized Eyes with Diabetic Macular Edema: A Two-Year Retrospective Analysis

2019 ◽  
Author(s):  
Ozgun Melike Gedar Totuk ◽  
Ayse Yagmur Kanra ◽  
Mohammed Nadim Bromand ◽  
Guler Kilic ◽  
Sevil Ari Yaylali ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Medical Records ◽  
Response To Treatment ◽  
Intravitreal Ranibizumab ◽  
Female Ratio ◽  
Corrected Visual Acuity ◽  
Baseline Values ◽  
Male To Female

Abstract Background: To compare the effectiveness of intravitreal ranibizumab (IVR) injections for the treatment of diabetic macular edema (DME) in eyes with and without previous vitrectomy. Methods: The medical records of 30 eyes (13 vitrectomized, 17 nonvitrectomized) of 28 patients (mean age, 59.09.6 years; male to female ratio 1:1) who were diagnosed with DME and had received IVR treatment were reviewed retrospectively. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and total macular volume (TMV) were measured at baseline and at months 6, 12, 18, and 24 of the follow-up. The number of IVR injections, the duration between diagnosis of DME and IVR injection, and hemoglobin A1c (HbA1c) level at baseline were also recorded. Results: Baseline demographics, HbA1c, BCVA, CMT, and TMV values were similar between the vitrectomized and nonvitrectomized groups (p>0.05). The duration between diagnosis of DME and IVR injections was longer in the nonvitrectomized group than in the vitrectomized group (165 years vs. 134 years, respectively; p=0.045). IVR injection was performed 6.3 times in vitrectomized eyes and 6.1 times in nonvitrectomized eyes during the 24-month period (p>0.05). BCVA improved significantly during the 24-month period in both groups. The improvement in BCVA was significant at month 6 in nonvitrectomized eyes, while there was no significant improvement in vitrectomized eyes before month 18. Compared to the baseline values, the decrease in both CMT and TMV was significant in months 6, 12, 18, and 24 in the nonvitrectomized group (p<0.05). In the vitrectomized group both CMT and TMV improved significantly only in months 18 and 24 (p<0.05). Conclusion: IVR treatment for DME is equally effective in both vitrectomized and nonvitrectomized eyes. However, the response to treatment is seen later in vitrectomized eyes compared to nonvitrectomized eyes.

Intravitreal ranibizumab in the treatment of subretinal neovascularization in a case of punctate inner choroidopathy

2011 ◽  
Vol 89 (s248) ◽  
pp. 0-0
Author(s):  
D PEREZ GARCIA ◽  
I PINILLA ◽  
B JIMENEZ DEL RIO ◽  
J IBANEZ ◽  
C PEIRO EMBID ◽  
...  
Keyword(s):  
Intravitreal Ranibizumab ◽  
Punctate Inner Choroidopathy ◽  
Subretinal Neovascularization

scholarly journals Swept Source-Optical Coherence Tomography Angiography for Management of Secondary Choroidal Neovascularization in Punctate Inner Choroidopathy

2021 ◽  
pp. 232-238
Author(s):  
Martin Stattin ◽  
Julia Forster ◽  
Daniel Ahmed ◽  
Katharina Krepler ◽  
Siamak Ansari-Shahrezaei
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Swept Source ◽  
Punctate Inner Choroidopathy ◽  
White Dot Syndrome ◽  
Oral Corticosteroids ◽  
Sd Oct

The purpose was to demonstrate the diagnostic and therapeutic feasibility of swept source-optical coherence tomography angiography (SS-OCTA) by picturing neovascular changes secondary to a rare white dot syndrome following long-term intravitreal ranibizumab (IVR). A 28-year-old Caucasian myopic female presented with visual loss in her right eye only. The clinical examination and multimodal imaging including spectral domain (SD)-OCT, blue-peak autofluorescence, fluorescein, and indocyanine green angiography (HRA Spectralis, Heidelberg Engineering; Heidelberg, Germany) as well as SS-OCTA (DRI Triton, Topcon; Tokyo, Japan) led to the diagnosis of idiopathic punctate inner choroidopathy with secondary subfoveal choroidal neovascularization (CNV). In addition to oral corticosteroids, a pro re nata regimen with IVR was initiated and guided by repeated SD-OCT and SS-OCTA. Six IVR were administered based on functional SS-OCTA en face scans illustrating vessel transformation and downsizing of the CNV area while SD-OCT B-scans were inconclusive as indirect signs of activity were absent throughout the follow-up period. SS-OCTA provided new possibilities for monitoring vessel development. IVR was managed based on vessel density as displayed by SS-OCTA.

scholarly journals Effect of intralesional platelet rich plasma in chronic localized vitiligo

2018 ◽  
Vol 4 (4) ◽  
pp. 550 ◽  
Author(s):  
Rashmi Mahajan ◽  
Kishan Ninama ◽  
Hinal Shah ◽  
Freny Bilimoria
Keyword(s):  
Platelet Rich Plasma ◽  
Topical Therapy ◽  
Calcineurin Inhibitors ◽  
Severity Index ◽  
Response To Treatment ◽  
Double Spin ◽  
Systemic Corticosteroids ◽  
Intralesional Injections ◽  
Autologous Platelet Rich Plasma ◽  
Destruction Of Melanocytes

<p class="abstract"><strong>Background:</strong> Vitiligo is a disease caused by destruction of melanocytes in lesional skin. It occurs worldwide in occurance of 0.1 to 2.0 percent. It is a multifactorial polygenic disease with complex pathogenesis. Several treatments, old and new are advocated for such patients. The first line of treatment includes topical corticosteroids and calcineurin inhibitors, and phototherapy (NBUVB, PUVA). The second line of treatment includes systemic corticosteroids, topical calcipotriol 0.005%, lasers such as excimer laser (308 nm).  The aim of the study was to evaluate the efficacy of platelet rich plasma in 40 cases of stable vitiligo with less than or equal to 1% body surface area involvement.</p><p class="abstract"><strong>Methods:</strong> 40 cases of stable vitiligo not responding to adequate topical therapy for more than 1 year were included in the study. They were subjected to intralesional injections of freshly prepared autologous platelet rich plasma (PRP) by double spin technique. Each patient was given injections every 2 weekly interwals for a total of 6 injections. Results were evaluated using the vitiligo area severity index (VASI) score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 40 patients15 Patients showed good response, 12 patients showed Average response and13 patients showed no response to treatment according to VASI score.</p><p class="abstract"><strong>Conclusions:</strong> PRP may be considered as an additional therapy in patients not responding adequately to traditional therapies. Our patients were not subjected to histopathology. It was also felt that patients might require more than 6 sittings for complete repigmentation.</p>

scholarly journals Analysis of the association between CFH Y402H polymorphism and response to intravitreal ranibizumab in patients with neovascular age-related macular degeneration (nAMD)

2018 ◽  
Vol 18 (3) ◽  
pp. 260-267 ◽  
Author(s):  
Nur Afiqah Mohamad ◽  
Vasudevan Ramachandran ◽  
Patimah Ismail ◽  
Hazlita Mohd Isa ◽  
Yoke Mun Chan ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Sample ◽  
Factor H ◽  
Age Related Macular Degeneration ◽  
Response To Treatment ◽  
Complement Factor ◽  
Variable Response ◽  
Intravitreal Ranibizumab ◽  
Age Related ◽  
Y402h Polymorphism

Pharmacogenetic studies indicate that a variable response to anti-vascular endothelial growth factor (VEGF) therapy in patients with neovascular form of AMD (nAMD) may be due to polymorphisms in the complement factor H gene (CFH). This study is the first to investigate the association between CFH Y402H polymorphism and the response to ranibizumab therapy in Malaysian patients with nAMD. We included 134 patients with nAMD, examined between September 2014 and February 2016. The diagnosis of nAMD was confirmed by ophthalmologic examination, before ranibizumab therapy was started. Each patient received an intravitreal injection of 0.5 mg/0.05 ml ranibizumab following a treat-and-extend (TE) regimen. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded after 3 and 6 months following the first injection and compared with the baseline values. Genotyping of Y402H (rs1061170) polymorphism was performed using PCR-RFLP and the amplified product was digested with MluCI restriction enzyme. Association between the Y402H genotypes and response to treatment was determined by a logistic regression analysis of responder (n = 49) and non-responder (n = 84) group. Significantly worse mean BCVA was observed for the CC genotype compared to the TT + CT genotype in the total sample after 6-month follow-up (p = 0.018). Comparing the baseline and 6-month point measurements, improved mean BCVA was observed in responder group, while worse mean BCVA was recorded for non-responder group. However, our regression analysis, adjusted for confounding factors, showed no significant association between the Y402H genotypes and response to treatment in nAMD patients under the recessive model (p > 0.05). Overall, our results suggest that factors other than Y402H polymorphism may be involved in the progression of nAMD after treatment with anti-VEGF agents, in Malaysian population.

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