scholarly journals Suspected Gentamicin-Induced Retinal Vascular Occlusion after Vitrectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 473-480 ◽  
Author(s):  
Fumiko Murao ◽  
Takamasa Kinoshita ◽  
Takashi Katome ◽  
Hiroki Sano ◽  
Masanori Niki ◽  
...  
Keyword(s):  
Vascular Occlusion ◽  
Perioperative Period ◽  
Retinal Hemorrhage ◽  
Optic Disk ◽  
Subconjunctival Injection ◽  
Ocular Surgery ◽  
Gas Tamponade ◽  
Retinal Vascular Occlusion ◽  
The Right ◽  
Arteries And Veins

Retinal vascular occlusion after ocular surgery is a rare but serious complication. A history of cardiovascular diseases, retrobulbar anesthesia injection, high intraocular pressure during the perioperative period, and drug toxicity have been reported as possible causative factors. We report here two cases of multiple retinal vascular occlusions after the subconjunctival injection of gentamicin at the end of uncomplicated 25-gauge vitrectomy. Case 1 was a 61-year-old man who developed a macular hole in the right eye. Phacovitrectomy with gas tamponade was performed. On postoperative day (POD) 1, dot hemorrhage was observed on the temporal side of the optic disk. On POD10, macular whitening, retinal hemorrhage, and multiple occlusion of retinal arteries and veins were observed. Case 2 was a 51-year-old woman who was diagnosed with rhegmatogenous retinal detachment in the right eye and underwent phacovitrectomy with gas tamponade. On POD3, macular whitening with cotton wool spots and retinal hemorrhage were observed with macular ischemia owing to occlusion of retinal arteries and veins. In both cases, subconjunctival injection of gentamicin given at the end of surgery was the most suspected cause of retinal vascular occlusion.

scholarly journals A Case of Presumed Dyskeratosis Congenita Causing Severe Retinal Vascular Occlusion

2021 ◽  
pp. 344-349
Author(s):  
Takahisa Hirokawa ◽  
Shou Oosuka ◽  
Masahiro Tonari ◽  
Hiroshi Mizuno ◽  
Teruyo Kida ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rare Case ◽  
Bone Marrow Failure ◽  
Vitreous Hemorrhage ◽  
Vascular Occlusion ◽  
Dyskeratosis Congenita ◽  
Vitreous Surgery ◽  
Hard Exudates ◽  
Retinal Vascular Occlusion ◽  
The Right

Dyskeratosis congenita (DKC) is a rare, multisystem, bone marrow failure disease characterized by abnormalities such as in the skin, mucosa, nervous system, and lungs. Here we report a rare case of presumed DKC causing total retinal detachment in the right eye and severe peripheral retinal vascular occlusion in the left eye. A 3-year-old boy was presented with vitreous hemorrhage and total retinal detachment in the right eye and was scheduled to undergo vitreous surgery in the right eye and detailed ophthalmologic examination of the left eye under general anesthesia. Since a systemic examination revealed anemia and marked thrombocytopenia, he underwent a detailed pediatric examination. Although genetic testing revealed no significant pathologic mutations, the presence of shortened telomere length and other clinical findings suggested the possibility of DKC. His right eye had severe proliferative vitreoretinopathy, and retinal reattachment was not achieved with vitreous surgery, thus resulting in phthisis bulbi. The left eye showed a wide retinal avascular area in the temporal retina, retinal neovascularization, and hard exudates on fluorescein fundus angiography and was treated with laser photocoagulation using a binocular indirect ophthalmoscopic photocoagulator. Following laser surgery, the new blood vessels regressed, and the visual acuity was maintained at 1.0. The findings in this rare case indicate that DKC can cause severe retinal vascular occlusion, thus leading to vitreous hemorrhage and retinal detachment. Therefore, early detection with fundus examination and early treatment with photocoagulation are important.

Acute retinal toxicity associated with a mixture of perfluorooctane and perfluorohexyloctane: failure of another indirect cytotoxicity analysis

2018 ◽  
Vol 103 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Rosa M Coco ◽  
Girish K Srivastava ◽  
Cristina Andrés-Iglesias ◽  
Jesús Medina ◽  
Fernando Rull ◽  
...  
Keyword(s):  
Ftir Spectroscopy ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Vascular Occlusion ◽  
Retinal Toxicity ◽  
International Standards ◽  
Gas Chromatography Mass Spectrometry ◽  
Ocular Surgery ◽  
Batch Number ◽  
Retinal Vascular Occlusion

AimsTo report new information related to acute retinal toxicity of Bio Octane Plus, a mixture of 90% perfluorooctane (PFO) and 10% perfluorohexyloctane.MethodsThis retrospective, descriptive case series reports the occurrence of acute retinal toxicity after vitreoretinal surgery in which Bio Octane Plus (batch number 1605148) was used as an endotamponade. Cytotoxicity biocompatibility tests and chemical analyses by Fourier-transformed infrared (FTIR) spectroscopy and gas chromatography-mass spectrometry (GC-MS) of the presumed toxic product were performed.ResultsFour patients presented with acute severe visual loss after uneventful ocular surgery assisted by Bio Octane Plus (batch number 1605148) as endotamponade. Patients experienced extensive retinal vascular occlusion leading to retinal and optic nerve atrophy. The viability of ARPE-19 cells directly exposed to the suspect batch for 30 min was 0%. The agarose overlay method used by the manufacturer according to European Union regulations and International Organization for Standardization (ISO) International Standards failed to detect toxicity. FTIR spectroscopy showed small differences between the non-toxic and toxic batches. GC-MS analysis showed the presence of bromotributyl stannane (whose toxicity was demonstrated in the dose–response curve) only in the toxic batch of Bio Octane Plus.ConclusionThis is the third report of retinotoxicity due to PFO in 4 years. The clinical profiles may be missed as they resemble other postsurgical complications; therefore, more cases worldwide could have gone unreported. Protocols to determine cytotoxicity of intraocular medical devices and approved by the ISO International Standards based on indirect methods have failed and should be revised to ensure safety.

Age, Gender, and Laterality of Retinal Vascular Occlusion: A Retrospective Study from the IRIS® Registry

2021 ◽  
Author(s):  
Yangjiani Li ◽  
Nathan E. Hall ◽  
Suzann Pershing ◽  
Leslie Hyman ◽  
Julia A. Haller ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Vascular Occlusion ◽  
Retinal Vascular Occlusion

scholarly journals Cervical artery dissection—an easily neglected cause of stroke: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ya -Hui Lian ◽  
Xin Chen ◽  
De- Rui Kong ◽  
Wei Chen ◽  
Ming-Chao Shi ◽  
...  
Keyword(s):  
Young People ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Vascular Occlusion ◽  
Artery Dissection ◽  
High Signal ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
The Right

Abstract Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

Retinal obliterative vasculitis associated to contralateral retinal neovascularization in membranoproliferative glomerulonephritis

2021 ◽  
pp. 112067212110143
Author(s):  
Michele Nicolai ◽  
Alessandro Franceschi ◽  
Nicola Vito Lassandro ◽  
Paolo Pelliccioni ◽  
Luca Danieli ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Membranoproliferative Glomerulonephritis ◽  
Vision Loss ◽  
Vascular Occlusion ◽  
Retinal Neovascularization ◽  
Vein Occlusion ◽  
Retinal Vascular Occlusion ◽  
Contralateral Eye ◽  
Peculiar Case

Purpose: To report our experience with a peculiar case of asynchronous bilateral retinal vascular occlusion in a patient suffering from membranoproliferative glomerulonephritis. Case report: A 57-year-old dialysed male affected by membranoproliferative glomerulonephritis who underwent kidney transplantation complained of a sudden vision loss in his right eye (RE). His best-corrected visual acuity (BCVA) was 20/40 in RE and 20/20 in the left eye (LE); ophthalmological and fluorangiographic examinations revealed unilateral retinal obliterative vasculitis with panuveitis and apparent sparing of contralateral eye. About 6 months later the patient developed a branch retinal vein occlusion associated with a papillary neovascular membrane in LE. Corticosteroid therapy was administered and immunosuppressant dosage was increased with macular oedema reduction in both events. Conclusion: We report a case of unilateral retinal obliterative vasculitis and subsequent contralateral retinal neovascularization and branch retinal vein occlusion in a patient affected by membranoproliferative glomerulonephritis.

scholarly journals Baicalein, Baicalin, and Wogonin: Protective Effects against Ischemia-Induced Neurodegeneration in the Brain and Retina

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Li Pan ◽  
Kin-Sang Cho ◽  
Irvin Yi ◽  
Chi-Ho To ◽  
Dong Feng Chen ◽  
...  
Keyword(s):  
Time Window ◽  
Therapeutic Potential ◽  
Vascular Dysfunction ◽  
Pathological Condition ◽  
Vascular Occlusion ◽  
Protective Effects ◽  
Scutellaria Baicalensis Georgi ◽  
Retinal Vascular Occlusion ◽  
Low Cytotoxicity ◽  
The Brain

Ischemia is a common pathological condition present in many neurodegenerative diseases, including ischemic stroke, retinal vascular occlusion, diabetic retinopathy, and glaucoma, threatening the sight and lives of millions of people globally. Ischemia can trigger excessive oxidative stress, inflammation, and vascular dysfunction, leading to the disruption of tissue homeostasis and, ultimately, cell death. Current therapies are very limited and have a narrow time window for effective treatment. Thus, there is an urgent need to develop more effective therapeutic options for ischemia-induced neural injuries. With emerging reports on the pharmacological properties of natural flavonoids, these compounds present potent antioxidative, anti-inflammatory, and antiapoptotic agents for the treatment of ischemic insults. Three major active flavonoids, baicalein, baicalin, and wogonin, have been extracted from Scutellaria baicalensis Georgi (S. baicalensis); all of which are reported to have low cytotoxicity. They have been demonstrated to exert promising pharmacological capabilities in preventing cell and tissue damage. This review focuses on the therapeutic potentials of these flavonoids against ischemia-induced neurotoxicity and damage in the brain and retina. The bioactivity and bioavailability of baicalein, baicalin, and wogonin are also discussed. It is with hope that the therapeutic potential of these flavonoids can be utilized and developed as natural treatments for ischemia-induced injuries of the central nervous system (CNS).

scholarly journals Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

2020 ◽  
Author(s):  
Mahdieh Azimizadeh ◽  
Seyedeh Maryam Hosseini ◽  
Esmaeil Babaei
Keyword(s):  
Choroidal Neovascularization ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Retinal Hemorrhage ◽  
Retinal Layers ◽  
Choroidal Osteoma ◽  
Focal Choroidal Excavation ◽  
Neurosensory Retina ◽  
The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

The right ventricle

2018 ◽  
Author(s):  
David Sidebotham ◽  
Alan Merry ◽  
Malcolm Legget ◽  
Gavin Wright
Keyword(s):  
Right Ventricle ◽  
Volume Overload ◽  
Perioperative Period ◽  
Final Part ◽  
Accurate Assessment ◽  
Characteristic Features ◽  
The Right ◽  
Rv Function

The first part of Chapter 12 details the relevant anatomy, physiology, and TOE views required for accurate assessment of the RV. Included are several useful imaging planes that are not presented in Chapter 4: Standard views. Next, the techniques for assessing global, regional, and diastolic RV function are outlined. The characteristic features of RV pressure and volume overload are described. The final part of the chapter brings together the information from the previous sections to provide an approach to assessing RV function during the perioperative period.

Ontogeny of neonatal pulmonary vascular pressure-flow relationships

1992 ◽  
Vol 262 (3) ◽  
pp. H684-H690 ◽  
Author(s):  
M. L. Tod ◽  
K. Yoshimura ◽  
L. J. Rubin
Keyword(s):  
Blood Flow ◽  
Pressor Response ◽  
Age Groups ◽  
Vascular Occlusion ◽  
Pressure Gradients ◽  
Age Group ◽  
Middle Region ◽  
Younger Age ◽  
Inhibition Of Prostaglandin Synthesis ◽  
Arteries And Veins

Previously we reported that pulmonary vascular pressure gradients determined by vascular occlusion varied as a function of neonatal age. The purpose of this study was to evaluate the effect of blood flow on pressure gradients during normoxia (inspired O2 28%) and hypoxia (inspired O2 4.2%) in isolated, indomethacin-treated lungs obtained from lambs at less than 1, 2-4, 12-14, and 30-32 days of age (n = 6 at each age). The total pulmonary pressure gradient was partitioned into pressure gradients across relatively indistensible arteries and veins and relatively compliant vessels in the middle region (delta Pm) by inflow and outflow occlusions at flows of 25, 50, 75, and 100 ml.kg-1.min-1. During normoxia, lungs from lambs less than 1 day of age had significantly greater pressures at each flow than lungs from older lambs, due primarily to a significantly greater delta Pm in this age group. During hypoxia, the greatest vasoconstriction occurred in the youngest group, also due mostly to an increased delta Pm. This enhanced response to hypoxia in the younger age groups was due to inhibition of prostaglandin synthesis; without indomethacin treatment, the older age groups had a greater hypoxic pressor response than the younger groups. The arterial vascular resistance at all ages was relatively constant as a function of blood flow during both normoxia and hypoxia, whereas the total and middle vascular resistances generally decreased as a function of flow. The venous resistance initially decreased and then was constant. These results suggest that the neonatal pulmonary circulation h as a fixed arterial resistance, a slightly distensible venous region at low flows, and a more distensible middle region.

scholarly journals Tolerability, kinetics, and efficacy of subconjunctival pefloxacin in pigmented rabbits.

1995 ◽  
Vol 39 (4) ◽  
pp. 834-838 ◽  
Author(s):  
S Marrakchi-Benjaafar ◽  
I Cochereau ◽  
F D'Hermies ◽  
J J Pocidalo
Keyword(s):  
Half Life ◽  
Maximum Concentration ◽  
High Performance ◽  
Histopathological Examination ◽  
Vitreous Humor ◽  
Subconjunctival Injection ◽  
Corneal Ulcers ◽  
Drug Concentrations ◽  
Pigmented Rabbits ◽  
The Right

Pefloxacin has been shown to have good intraocular penetration when given systemically. In order to extend its clinical use, we have assessed the tolerability, kinetics, and efficacy of subconjunctival pefloxacin in phakic pigmented rabbits. The tolerability of a single subconjunctival injection of pefloxacin (0.8, 1.6, 8, or 16 mg in 0.2 ml) in the right eyes of eight rabbits was evaluated by clinical and histopathological examination. The 0.8-mg dose of pefloxacin was well tolerated. The kinetics was evaluated after a single subconjunctival injection of 0.8 mg in 18 rabbits. Animals were sacrificed at 1, 3, 5, 7, 12, or 18 h postinjection. Drug concentrations were measured by high-performance liquid chromatography. Pefloxacin was found in the cornea (maximum concentration, 18.13 micrograms/ml; half-life, 3.92 h) and in the aqueous humor (maximum concentration, 3.40 micrograms/ml; half-life, 2.14 h). Pefloxacin did not penetrate into the vitreous humor by this route. The efficacy was evaluated in an experimental model of staphylococcal corneal ulcers in eight rabbits which received two subconjunctival injections of 0.8 mg of pefloxacin at 16 and 24 h after intrastromal inoculation. The results (expressed as mean log10 CFU per milliliter +/- standard deviation) showed that pefloxacin significantly (P < 0.001) reduced the bacterial counts (4.39 +/- 0.97) compared with those in control eyes (6.46 +/- 0.69). For phakic eyes, subconjunctival pefloxacin might be of value for the treatment of corneal ulcers. Further studies are required to determine its penetration into the vitreous humor of aphakic eyes.

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