scholarly journals Peripheral Retinal Neovascularization in a Patient with Sarcoidosis and Cocaine-Associated Autoimmunity

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ramak Roohipourmoallai ◽  
Samaneh Davoudi ◽  
Seyed Majid Hosseinian Benvidi ◽  
Siva S. R. Iyer
Keyword(s):  
Macular Hole ◽  
Cocaine Abuse ◽  
Systemic Vasculitis ◽  
Retinal Vasculitis ◽  
Visual Disturbance ◽  
Lymph Node Biopsy ◽  
African American Female ◽  
Full Thickness Macular Hole ◽  
History Of ◽  
The Right

A 63-year-old African-American female with history of sarcoidosis (lymph node biopsy proven) and cocaine abuse for 8 years was referred to us because of new floater. Her ocular history was unremarkable except for vague complaints of visual disturbance during a hospital admission in 2016. On presentation, her visual acuity was 20/400 in the right eye and 20/30 in the left eye. Dilated fundus exam and multimodal imaging showed thick epiretinal membrane (ERM) superior to optic nerve head causing a lamellar macular hole and intra retinal edema in the right eye, a full thickness macular hole, and peripheral neovascularization in the left eye. Peripheral vasculitis was appreciated in both eyes and peripheral neovascularization in the left eye on fluorescein angiography. The patient underwent laser therapy, and the new vessels regressed in the left eye without any changes in systemic medications. Multiple factors may contribute to retinal vasculitis and neovascularization including sarcoidosis, cocaine abuse, and other undiagnosed systemic vasculitis, which makes this case a mystery.

scholarly journals Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Spontaneous Closure ◽  
Surgical Removal ◽  
Lamellar Macular Hole ◽  
Full Thickness ◽  
Stage 4 ◽  
Full Thickness Macular Hole ◽  
The Right ◽  
Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

scholarly journals A rare cause of wheezing

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Alexander H. Cho ◽  
Jessica Logan ◽  
Jalil Ahari
Keyword(s):  
Granular Cell ◽  
African American Female ◽  
Lobe Bronchus ◽  
Submucosal Tumors ◽  
Sputum Production ◽  
Endobronchial Lesion ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

A 24-year-old African American female nonsmoker, with a reported history of asthma presented to the hospital with 2 weeks of shortness of breath and sputum production. She had a chest X-ray and computed tomography scan that displayed evidence of a right upper lobe collapse. She subsequently had a bronchoscopy that revealed an endobronchial lesion at the opening of the right upper lobe bronchus. Biopsies performed were consistent with a granular cell tumor. Granular cell tumors are rare submucosal tumors of Schwann cell origin. Resection of the right upper lobe resolved her symptoms and wheezing.

Arc flash macular hole

2020 ◽  
pp. 112067212097623
Author(s):  
Ruminder Kaur ◽  
Prateek Koul
Keyword(s):  
Laser Beam ◽  
Macular Hole ◽  
Electric Shock ◽  
Light Exposure ◽  
Full Thickness ◽  
Bright Flash ◽  
Macular Holes ◽  
Full Thickness Macular Hole ◽  
History Of ◽  
Arc Flash

Macular holes are common. Lightening, direct electric shock induced and laser beam induced macular holes are though rare. Reporting a case of spark flashlight (Arc Flash) induced macular hole in an electrician, which has never been reported. A 19 year old male electrician by profession presented to our clinic with a history of exposure to a bright flash light from spark of wires while at work that led to decrease of vision in his both eyes. Examination revealed a full thickness macular hole in his right eye and loss of foveal photoreceptors in the left eye. Arc flash light exposure in electricians can lead to macular holes too adding a new entity to the already existing types of macular holes.

Lyme disease atypically presenting with a singular symptom: Unilateral chorioretinitis

2020 ◽  
pp. 112067212096205
Author(s):  
Erol Havuz ◽  
Seda Güdül Havuz
Keyword(s):  
Visual Acuity ◽  
Lyme Disease ◽  
Retinal Vasculitis ◽  
Ocular Involvement ◽  
Ischemic Optic Neuropathy ◽  
Sudden Loss ◽  
Patient Reported ◽  
History Of ◽  
Verification Test ◽  
The Right

Background: Lyme disease, caused by Borrelia burgdorferi, is a spirochetal disease. Lyme disease-related ocular findings may also provide important clues. Ocular involvement is most commonly seen as uveitis, chorioretinitis, conjunctivitis, keratitis, episcleritis, papillitis, panuveitis, ischemic optic neuropathy, papilledema, and retinal vasculitis. Case: A 27-year-old male patient was admitted with a history of fatigue, malaise, and sudden loss of vision in his left eye for 3 days. The best visual acuity was found 20/20 in the right eye and 20/400 in the left eye. Fluorescein fundus angiography showed no pathological findings in the right eye; but hyperfluorescence that was compatible with choroiditis foci was seen in the left eye. Optical coherence tomography (OCT) showed choroidal thickening in the left eye compared to the right eye. Lyme IgM antibody was found to be positive, explaining choroiditis etiology, while IgG values were found to be negative. Western blot verification test was positive. The patient was treated with 2 × 100 mg doxycycline (21 days) with a diagnosis of Lyme disease, prednol 1 mg/kg/day (10 days) for choroiditis. Omeprazole tablets were given 1 × 1 during the period of cortisone intake. On the third day of treatment, visual acuity increased to 20/200 and continued to increase until reaching 20/20 in the second week. Conclusions: Lyme disease is rare, but must be kept in mind when investigating the etiology of chorioretinitis and retinal vasculitis. The patient reported here is, to our knowledge, the second case reported in literature that shows atypical clinic for Lyme disease with unilateral chorioretinitis without Erythema chronicum migrans (ECM).

Spontaneous Closure of a Macular Hole in Macular Telangiectasia Type 2

2020 ◽  
pp. 247412642095890
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
Mark Gillies
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Spontaneous Closure ◽  
Full Thickness ◽  
External Limiting Membrane ◽  
Macular Telangiectasia ◽  
History Of ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: Spontaneous closure of a macular hole in macular telangiectasia type 2 (MacTel) with vision improvement is described. Methods: A case report is presented. Results: A 71-year-old man presented with a 1-week history of distorted vision in his left eye. Left visual acuity (LVA) was 20/80. Optical coherence tomography showed an almost full-thickness left macular hole with an intact internal limiting membrane drape. Small inner retinal cavitations were present at the right macula; multimodal imaging confirmed MacTel. Managed conservatively, at 5 months the patient’s LVA had improved to 20/60, the defect was no longer full thickness, and the external limiting membrane had reconstituted. At the right macula, the inner cavitations grew and outer cavitations developed, but the external limiting membrane remained intact. At 32 months, right VA was 20/20 and LVA was 20/40. Conclusions: This case of MacTel with spontaneous closure of a macular hole was associated with an overlying internal limiting membrane drape.

Posterior orbital cellulitis: case report and literature review

2013 ◽  
Vol 127 (11) ◽  
pp. 1148-1151 ◽  
Author(s):  
K Allan ◽  
H Atkinson ◽  
F Agada
Keyword(s):  
Case Report ◽  
Relevant Literature ◽  
Clinical Signs ◽  
Visual Disturbance ◽  
Orbital Cellulitis ◽  
Sphenoid Sinusitis ◽  
Intravenous Antibiotics ◽  
Permanent Loss ◽  
History Of ◽  
The Right

AbstractIntroduction:It is rare for isolated sphenoid sinusitis to cause orbital cellulitis. We present a rare case of posterior orbital cellulitis, so caused, together with a review of the relevant literature.Case report:A 29-year-old woman presented with a 6-week history of progressive, unilateral, retro-orbital and periorbital right eye pain. On examination, the only finding was reduced visual acuity in the right eye. A computed tomography scan demonstrated right frontal and sphenoid sinus opacification. Sphenoidotomy and frontal sinus trephination were subsequently performed, following failure to respond to intravenous antibiotics. After surgery, the patient's vision returned to normal.Conclusion:Isolated sphenoid sinusitis is rare but can cause significant visual disturbance and permanent loss of vision. Vague symptoms unsupported by clinical signs at presentation are a feature of posterior orbital cellulitis. The presented case highlights the problem, and the need for a high index of clinical suspicion even in the absence of firm clinical signs, in order to prevent permanent visual loss.

scholarly journals Diagnosis and Management of Macular Holes Traumatic

2019 ◽  
Vol 2 (1) ◽  
pp. 38-45
Author(s):  
Reny Violeta ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Macular Hole ◽  
Blunt Trauma ◽  
Internal Limiting Membrane ◽  
Photoreceptor Layer ◽  
Macular Holes ◽  
Younger Age ◽  
History Of ◽  
Amsler Grid ◽  
The Right ◽  
First Time

Introduction. Macular hole is a defect in the retina involving the macula and fovea, in the form of damage to full thickness from the internal limiting membrane (ILM) to the outermost part of the photoreceptor layer . It was more often found in women. In patients with myopia disorders can be found at a younger age. In this case we report the macular hole caused by blunt trauma, as was the first time a macular hole case was discovered. Case Presentation. A man 24-year-old, Mr. C, came to Palembang RSMH eye clinic on August 15, 2014 with complaints of blurred right eye vision. Main Complaints: Right eye blurred. History Disease: Right eye blurred for about 3 months before entering the hospital. Blur is felt after the patient had a motorcycle accident 3 months ago. At that time the collision sufferer avoided the truck, the right eye hit the motorcycle handlebar, the patient then fell from the motorcycle and hit the highway head. A history of frequent headaches is denied, nausea, vomiting is denied, history of seeing in tunnels is denied. Supporting examination is Amsler Grid Oculi Dextra: there is a black hole in the middle of the image. differential diagnosis is Traumatic Macular Hole OD, Lamellar Macular Hole OD, work diagnosis is Traumatic Macular Hole stage 3 OD. Conclusion. Traumatic macular holes can occur immediately after blunt trauma to the eyeball, the accuracy of the diagnosis and the speed of the timing for surgery, greatly determining the prognosis. Vitrectomy and combined with internal limiting membrane peeling have been shown to provide excellent results in macular surgery in macular hole cases.

scholarly journals Polyadenopathy - A Multidisciplinary Approach

2020 ◽  
Vol 17 (2) ◽  
pp. 61-72
Author(s):  
Alexandra Jichitu ◽  
Laura Maria Manea ◽  
Vlad Pînzariu ◽  
Nicoleta Mihaela Sprîncenatu ◽  
Irina Iuliana Hanu ◽  
...  
Keyword(s):  
Systemic Vasculitis ◽  
Lymph Node Biopsy ◽  
The Body ◽  
Maximum Diameter ◽  
Significant Past Medical History ◽  
Presumptive Diagnosis ◽  
Superior Mediastinum ◽  
Multisystemic Disease ◽  
Necrotizing Granuloma ◽  
The Right

AbstractIntroduction. Sarcoidosis is a multisystemic disease, that can basically affect any organ of the body, the lungs and the intrathoracic lymph nodes being the most affected. Despite the attempts to understand the exact pathogenic mechanism of the disease, this continues to remain uncertain. Histopathologically, the trademark of sarcoidosis is the presence of nonnecrotizing granuloma.Case presentation. We report the case of a 33-year-old man without significant past medical history, who is admitted to our clinic for bilateral supraclavicular and axillary adenopathies, progressive asthenia for the last three months and pain in the latero-thoracic region. The patient denies weight loss, odynophagia and fever.Clinically, the patient is afebrile and has supraclavicular, bilateral laterocervical and axillary adenopathies which are painless, elastic and mobile with a maximum diameter of 1.5 cm. The prehepatic diameter is 16 cm, with rounded inferior edge and the spleen in not palpable.The laboratory tests reveal moderate inflammatory syndrome, with C-reactive protein (CRP) of 1.4mg/dL (N<0.5mg/dL) and the erythrocyte sedimentation rate (ESR) 65mm/h (N<40mm/h). There is no lymphocytosis or neutrophilia. The ENT (Ear Nose Throat) consultation found no evidence of angina and, combined with the paraclinical investigations, excluded mononucleosis.Thus, the presumptive diagnosis was difficult because of the non-specific symptomatology and included the following: lymphoma, mononucleosis, sarcoidosis, tuberculosis and systemic vasculitis.The chest X-ray reveals enlarged pulmonary hilums, diffuse outlined-adenopathic/tumoral aspect, diffuse changes in the pulmonary interstitium and micronodular opacities of medium intensity, being diffusely outlined with the tendency of basal merging on the left side and slight asymmetrical enlargement of the superior mediastinum on the right side, para trachealadenopathic aspect.The lymph node biopsy reveals the aspect of non-necrotizing granuloma, which suggests the diagnosis of sarcoidosis.We used the dosage of angiotensin convertase, which reveals high values of 108.20U/L (N 13.3-63.9 U/L). Therefore, a pulmonary clinical evaluation was recommended.Conclusion. Case of 33-year-old man with sarcoidosis. The diagnosis was difficult, considering the non-specific symptomatology and the numerous pathologies that can be included in the differential diagnosis.

scholarly journals Giant bilateral axillary artery aneurysms with left complete obstructive thrombus in intravenous immunoglobulin-sensitive Kawasaki disease: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Chu ◽  
Lan He ◽  
Yi-xiang Lin ◽  
Li-ping Xie ◽  
Fang Liu
Keyword(s):  
Kawasaki Disease ◽  
Upper Limb ◽  
Axillary Artery ◽  
Systemic Vasculitis ◽  
Systemic Artery ◽  
Low Dose Aspirin ◽  
History Of ◽  
Normal Ultrasound ◽  
Collateral Vessels ◽  
The Right

Abstract Background Kawasaki disease (KD) is a systemic vasculitis that predominantly affects medium-sized arteries. In addition to well-known coronary artery aneurysms (CAAs), peripheral systemic artery aneurysms (SAAs) have also been sporadically reported. In the literatures, SAAs occurred mainly in untreated, intravenous immunoglobin (IVIG)-resistant, or severe refractory KD, and thrombotic events in SAAs were rarely reported. Case presentation A 10-month-old boy with a history of KD was referred to our hospital for suspected pseudoaneurysm of the axillary arteries. Four months prior to presentation, he had persistent fever, conjunctival congestion, and rash. On the 10th day of fever echocardiogram showed biliteral CAAs. He was then diagnosed with KD and given IVIG 2 g/kg and aspirin at a local hospital. His fever and symptoms soon subsided and he was discharged with low dose aspirin and dipyridamole. One month prior to presentation, his parents incidentally palpated swellings in his bilateral axillae. On admission, physical examination revealed a pulsatile swelling in his right axilla and a non-pulsatile swelling in the left with impalpable left brachial and radial pulses, cooler and less active left upper limb than the right one. While the pulses of other three limbs were normal. Ultrasound examination revealed giant bilateral axillary artery aneurysms (AAAs) with massive thrombus in the left. Angiography confirmed giant bilateral AAAs with left AAAs completely occluded and fine collateral vessels connecting to the distal brachial artery, in addition to giant bilateral multiple CAAs without stenoses. The patient was given intravenous prostaglandin for 10 days to allow for formation of collateral circulation, as well as aspirin, low molecular weight heparin (which was switched to warfarin before discharge) and metoprolol. At discharge, the temperature and movement of his left upper limb improved significantly. On follow-up at 7 months, his left upper limb further improved and was similar to the right with no occurrence of cardiovascular events. The images of CAAs and AAAs on echocardiogram and computerized tomography remained the same. Conclusions This case highlights the importance of evaluating peripheral SAAs in KD patients with CAAs, even if their course of treatment appears smooth. For both large non-aortic SAAs and CAAs in KD patients, antithrombotic therapy is of utmost importance.

scholarly journals Cocaine-Induced Giant Bullous Emphysema

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Steven Douedi ◽  
Vandan D. Upadhyaya ◽  
Ishan Patel ◽  
Usman Mazahir ◽  
Eric Costanzo ◽  
...  
Keyword(s):  
Cocaine Abuse ◽  
Stable Condition ◽  
Lung Parenchyma ◽  
Case Presentation ◽  
Chronic Cocaine ◽  
Giant Bulla ◽  
History Of ◽  
Alpha 1 Antitrypsin ◽  
Lung Periphery ◽  
The Right

Background. Emphysematous bullae, defined as airspaces of greater than or equal to one centimeter in diameter, have a variety of etiologies such as tobacco use and alpha-1 antitrypsin being the most common. Emphysematous bullae have also been reported in patients using cocaine usually involving the lung periphery and sparing the central lung parenchyma. We present a case of a male with a history of cocaine abuse found to have a singular giant emphysematous bulla occupying >95% of the right hemithorax requiring video-assisted thoracic surgery (VATS) with a favorable outcome. Case Presentation. A 50-year-old male with a history of chronic cocaine abuse was found unresponsive in the field and given multiple doses of naloxone without any improvement in mental status. On presentation to the emergency department, chest X-ray as well as CT scan of the chest were performed which were suggestive of an extensive pneumothorax of the right lung requiring placement of a chest tube. The patient was subsequently intubated and underwent bronchoscopy with right chest VATS which found a giant bulla encasing the entire right pleural cavity. During the procedure, he underwent resection of the bullae and a partial right pleurodesis. After the procedure, patient’s respiratory status significantly improved, and he was discharged in a stable condition. Conclusion. Cocaine use is a rare but identifiable factor that can cause giant bullous emphysema (GBE) resulting in severe complications and even death. The purpose of this case presentation is to support early identification and treatment of GBE using bullectomy with VATS, improving outcomes and decreasing morbidity and mortality.

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