scholarly journals Management of Systemic Steroid in HIV Patient with Toxoplasma Papillitis

2019 ◽  
Vol 7 (11) ◽  
pp. 1821-1824
Author(s):  
AA Mas Putrawati Triningrat ◽  
Ratna Sari Dewi ◽  
Igam Juliari ◽  
NK Niti Susila ◽  
Ni Made Ayu Surasmiati ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Systemic Steroid ◽  
Laboratory Examination ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
The Right

BACKGROUND: Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii. Ocular manifestations are seen in both congenital and acquired toxoplasmosis. These can include focal inflammation within or around the optic nerve head (papillitis). Purpose of this study is evaluating the efficacy of systemic steroid in HIV patient with toxoplasma papillitis. CASE PRESENTATION: We present a case report of a male, 46 years old with a decrease of visual acuity on the right eye for three weeks before admission to the hospital. An ophthalmology examination showed visual acuity of the right eye 1/60, mild dilatation of the pupil and posterior synechiae, vitreous was hazy, and fundus examination showed optic nerve head not well demarcated and hyperaemic with the good retina and macula reflex. Laboratory examination showed reactive anti-Toxoplasma immunoglobulin G. Patient had been treated with antiretroviral and anti-Toxoplasma drugs, then he was given steroid 250 mg intravenously four times per day for three days and tapering off orally. Visual acuity on the right eye improve from 1/60 became 6/60 after use of steroid on the third day. DISCUSSION: Steroid can improve visual acuity for toxoplasma papillitis in this patient. But the long term and close follow up in steroid therapy is needed.

Long-term efficacy of fractionated conformal radiotherapy for the management of primary optic nerve sheath meningioma

2018 ◽  
Vol 103 (10) ◽  
pp. 1436-1440 ◽  
Author(s):  
Ravi Pandit ◽  
Liliana Paris ◽  
Danielle S Rudich ◽  
Robert L Lesser ◽  
Mark J Kupersmith ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Symptom Onset ◽  
Conformal Radiotherapy ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
The Mean

Background/AimFractionated conformal radiotherapy (FCRT) is now used to treat vision-threatening optic nerve sheath meningioma (ONSM), but long-term efficacy and safety data are lacking; the purpose of this study was to assess these key data.MethodsThis is a retrospective chart review with prospective follow-up of adult patients treated with FCRT for primary ONSM at four academic medical centres between 1995 and 2007 with ≥10 years of follow-up after treatment.Results16 patients were identified with a mean post-treatment follow-up of 14.6 years (range: 10.5–20.7 years). The mean age at symptom onset was 47.6 years (range: 36–60 years). FCRT was performed at a mean of 2.3 years after symptom onset (range: 0.2–14.0 years). At last follow-up, visual acuity had improved or stabilised in 14 of the 16 (88%) patients, and 11 (69%) had retained or achieved ≥20/40. The mean deviation on automated perimetry remained stable (−14.5 dB pretreatment vs −12.2 dB at last follow-up; p=0.68, n=10). Two (11%) patients had persistent pain, proptosis or diplopia, compared with six (38%) pretreatment (p=0.11). Two (13%) patients developed radiation retinopathy more than 6 months after completion of therapy, one (50%) of whom had worse visual acuity compared with pretreatment. No patient developed tumour involvement or radiation damage in the fellow eye.ConclusionFCRT stabilises or improves visual function in patients with primary ONSM and is associated with a low risk of significant ocular sequelae. This treatment should be considered instead of surgery in patients with primary ONSM who require intervention due to loss of visual sensory and/or ocular motor function.

scholarly journals IMPROVEMENT OF LEUKEMIC RETINOPATHY AFTER LEUKAPHERESIS IN CHRONIC MYELOGENOUS LEUKEMIA WITH LEUKOSTASIS

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Ruchyta Ranti ◽  
Sauli Ari Widjaja ◽  
Wimbo Sasono ◽  
Muhammad Firmansjah ◽  
Ima Yustiarini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Chronic Myelogenous Leukemia ◽  
Visual Disturbance ◽  
Myelogenous Leukemia ◽  
Laboratory Examination ◽  
Retinal Hemorrhages ◽  
Case Presentation ◽  
Retinal Blood Vessels ◽  
Wbc Count ◽  
The Right

ABSTRACT Introduction: to report a case of bilateral leukemic retinopathy due to leukostasis that was successfully managed by leukapheresis. Case Presentation: 31-year-old male with mild visual disturbance was referred to ophthalmology department. He suffered from Chronic Myelogenous Leukemia (CML) with white blood cell (WBC) count 533.900/microL. He was started on hydroxyurea, allopurinol, and once leukapheresis. Ophthalmologic evaluation revealed visual acuity of 4/4 in the right eye and 4/6,3 in the left eye. Funduscopy examination showed the presence of bilateral papilledema, venous engorgement, tortuosity, and retinal hemorrhages. Then this patient continued with second leukapheresis. Result: Visual acuity, laboratory examination, and funduscopic finding was evaluated. His visual acuity was improved, papilledema and retinal blood vessels abnormality had markedly reduced concurring with the patient’s hematological remission. Decreasing WBC count after leukapheresis has improved blood flow that reflected from the retinal findings and visual acuity improvement. Conclusion: Leukapheresis treatment is sufficient to improved clinical condition for leukemic retinopathy caused by CML with leukostasis. Keywords: chronic myelogenous leukemia (CML), hyperleukocytosis, leukostasis, leukemic retinopathy

scholarly journals Arginine-Restricted Therapy Resistant Bilateral Macular Edema Associated with Gyrate Atrophy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Sibel Doguizi ◽  
Mehmet Ali Sekeroglu ◽  
Mustafa Alpaslan Anayol ◽  
Pelin Yilmazbas
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Peripheral Zone ◽  
Restricted Diet ◽  
Comprehensive Understanding ◽  
Gyrate Atrophy ◽  
Case Presentation ◽  
Corrected Visual Acuity

Introduction. Gyrate atrophy is a rare genetical metabolic disorder affecting vision. Here, we report a 9-year-old boy with gyrate atrophy associated with bilateral macular edema at the time of diagnosis and the effect of long term metabolic control on macular edema.Case Presentation. A 9-year-old boy presented with a complaint of low visual acuity (best corrected visual acuity: 20/80 in both eyes, refractive error: −12.00 D). Dilated fundus examination revealed multiple bilateral, sharply defined, and scalloped chorioretinal atrophy areas in the midperipheral and peripheral zone. Spectral-domain optical coherence tomography revealed bilateral cystoid macular edema in both eyes. Serum ornithine level was high (622 μmol/L). An arginine-restricted diet reduced serum ornithine level (55 μmol/L). However, visual findings including macular edema remained unchanged in 2 years of follow-up.Conclusion. Arginine-restricted diet did not improve macular edema in our patient with gyrate atrophy. A more comprehensive understanding of the underlying factors for macular edema will lead to the development of effective therapies.

scholarly journals Dementia with aphasia and mirror phenomenon: examination of the mechanism using neuroimaging and neuropsychological findings: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aiko Osawa ◽  
Shinichiro Maeshima ◽  
Hidenori Arai ◽  
Izumi Kondo
Keyword(s):  
Parietal Lobe ◽  
Underlying Mechanism ◽  
Mirror Image ◽  
Case Presentation ◽  
Frontal Lobe Function ◽  
Long Term Follow Up ◽  
The Right ◽  
Neuropsychological Findings

Abstract Background Aphasia often appears in persons living with dementia; however, aphasia and the mirror phenomenon are rarely present at the same time. Case presentation Here, we report a case of fluent conversation with a person in a mirror or a magazine, and examine the underlying mechanism using brain imaging and neuropsychological findings. We found that the appearance of the mirror phenomenon may be associated with a visuospatial dysfunction caused by a decreased function of the posterior region of the right temporal and parietal lobe. Moreover, active talking to a person in a mirror or a person in a magazine could be associated with disinhibition caused by a decline in bilateral frontal lobe function. Conclusions This case represents a very valuable and interesting presentation because it is the first report of a long-term follow-up of the course of dementia using neurological imaging, and of the neuropsychological analysis of the mechanism of conversation with a mirror image combined with aphasia.

Long term follow-up of retinal nerve fiber layer thickness in eyes with optic nerve head drusen

2003 ◽  
Vol 26 (5) ◽  
pp. 277-280 ◽  
Author(s):  
Ozcan Ocakoglu ◽  
Can Ustundag ◽  
Nilufer Koyluoglu ◽  
Velittin Oguz ◽  
Gurhan Kendiroglu ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Nerve Fiber ◽  
Layer Thickness ◽  
Optic Nerve Head ◽  
Fiber Layer ◽  
Nerve Fiber Layer Thickness ◽  
Optic Nerve Head Drusen ◽  
Long Term Follow Up

scholarly journals Optic nerve head recovery following the iop-lowering surgery in the eye with early juvenile glaucoma-nine years follow up

2018 ◽  
Vol 75 (8) ◽  
pp. 826-831
Author(s):  
Vujica Markovic ◽  
Dragan Vukovic ◽  
Ivan Marjanovic ◽  
Sanja Petrovic-Pajic ◽  
Aleksandra Radosavljevic ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Nerve Tissue ◽  
Eye Disease ◽  
Treatment Results ◽  
Adequate Treatment ◽  
Neuroretinal Rim ◽  
Juvenile Glaucoma

Introduction. Congenital uveal ectropion (CEU) is a rare, non-progressive condition often accompanied with eyelid ptosis, anterior insertion of the iris, disgenesis of the iridocorneal angle and glaucoma. Case report. We present a case of a seven-year-old girl with a congential unilateral uveal ectropion and a secondary glaucoma which had daily variations from 13 up to 50 mm Hg. The patient had no other abnormalities of the iris or underlying systemic diseases. Introduced local anti-glaucomatous therapy initially normalized intraocular pressure (IOP), but failed to provide long term normalisation. Trabeculectomy normalized the IOP which resulted in the reduction of the cup/disc ratio and restitution of neuroretinal rim. The rim area increased to 1.716 mm2 (0.958 mm2 preoperative) rim volume, was 0.666 mm3 (0.195 mm3 preoperative) while cupdisc (C/D) ratio decreased to 0.330 (0.626 preoperative) as well as linear C/D=0.574 (0.791 preoperative). Neuroretinal rim (NR) was preoperatively preserved in the Ti segment, damaged in T, Ts, N, Ns segments, and borderline in the Ni segment. Postoperatively, neuroretinal rim was preserved in all segments. Conclusion. In the presented case trabeculectomy induced recovery of the nerve tissue of the optic nerve head which was confirmed by Haidelberg Retina Tomograph II (HRT II). The treatment results have been maintained during the follow-up period of nine years without topical or systemic antiglaucomatous therapy. Although CEU is a non-progressive and benign eye disease, associated glaucoma can cause severe optic nerve damage if not detected early and treated properly. As can be seen in the presented case, an adequate treatment can prevent and even reverse optic disc neuropathy.

scholarly journals HIPERTENSÃO OCULAR SECUNDÁRIA À LUXAÇÃO DE CRISTALINO PARA CÂMARA ANTERIOR NA SÍNDROME DE MARFAN

2022 ◽  
Vol 13 (2) ◽  
pp. 19-24
Author(s):  
Daniel Prado Beraldo ◽  
Fernando Buzatto Mantovan ◽  
Emanuele Moraes Mello
Keyword(s):  
Visual Acuity ◽  
Severe Pain ◽  
Autosomal Dominant ◽  
Ectopia Lentis ◽  
Iol Implantation ◽  
Ocular Manifestations ◽  
Post Operative Period ◽  
Fibrillin 1 ◽  
The Right

Marfan syndrome (MFS) is a rare autosomal dominant metabolic disorder, caused by mutations in the gene responsible for coding the fibrillin-1 protein. It is characterized by cardiovascular, musculoskeletal and ocular manifestations. The purpose of this report was to present a rare ophthalmologic complication in a patient with MFS. Female, 51 years old, attended the emergency room complaining of severe pain, low visual acuity and hyperemia in the right eye, started two days before. Biomicroscopy: ectopia lentis (luxated) for anterior chamber; Tonometry: 56 mmHg. Hypotensive drugs were prescribed which reduced intraocular pressure (IOP) to 8 mmHg. Referred for emergency surgery (facectomy without IOL implantation) in order to avoid further damage to the cornea and optic nerve. In the post operative period, presented IOP control and improved VA to 20/50. Multidisciplinary follow-up is necessary in patients with MFS, enabling early diagnosis, which can prevent and minimize any complications.

scholarly journals Ocular Chemical Burn with an Unusual Presentation: A Case Report

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Malihe Nikandish
Keyword(s):  
Case Report ◽  
Chemical Burn ◽  
Surface Chemical ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
The Right ◽  
Topographic Parameters ◽  
Irregular Astigmatism

Introduction: Ocular chemical injury is an ophthalmic emergency that may be challenging to manage. Here, we presented a case of persistent corneal astigmatism secondary to chemical burn with superficial limbal injury and no corneal involvement. Case Presentation: The case was a 36-year-old man who presented with a chemical acid injury in the right eye. He had sectorial superficial involvement of inferior limbus from 4 to 5 o'clock hours, and the cornea was clear. Corneal topography showed high irregular astigmatism that was not corrected with glass. In long-term follow-up, changes in topographic parameters happened very slowly. Conclusions: In conclusion, optical corneal changes should be considered in the ocular surface chemical burn, especially in sectorial involvement despite clear cornea.

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