RESUMEN
PURPOSE: To examine the rate of ciliary body detachment in patients with choroidal detachment following glaucoma surgery and its effect on the clinical course, management, and prognosis. METHODS: A prospective observational case-series study. Patients with choroidal detachment following glaucoma surgery in 2018-2019 were included. All underwent complete ophthalmological examination and ultrasound biomicroscopy for evaluation of the presence and extent of ciliary body detachment. Follow-up examinations including ultrasound biomicroscopy scans were performed at 1 week, 1 month, 3 months, and 6 months. RESULTS: Eight patients (8 eyes) were enrolled, 4 male and 4 female, of mean age 72 years (range 60-83). Five patients underwent trabeculectomy with mitomycin C (0.02%), which was combined with phacoemulsification cataract extraction in one; two underwent Ahmed glaucoma valve implantations, and one underwent ab-interno Xen45 gel stent implantation with mitomycin C (0.02%). The mean intraocular pressure was 26.0 ± 7.65 mmHg preoperatively, dropping to 6.9 ± 2.64 mmHg on first postoperative day one. Mean time from surgery to diagnosis of choroidal detachment was 11.6 ± 5.73 days. Ciliary body detachment was identified by ultrasound biomicroscopy in all patients, ranging between one and four quadrants. All patients were treated with topical steroids and cycloplegics; three (37.5%) received oral steroids. No surgical intervention for the choroidal or ciliary body detachments was indicated. CONCLUSIONS: In this real-world prospective study, concurrent ciliary body detachment was identified in all patients who presented with choroidal detachment following glaucoma surgery. This observation may deepen our understanding of the mechanism underlying the hypotony that is often seen after glaucoma surgery.
Asunto(s)
Efusiones Coroideas , Cuerpo Ciliar , Glaucoma , Presión Intraocular , Humanos , Masculino , Femenino , Anciano , Estudios Prospectivos , Persona de Mediana Edad , Anciano de 80 o más Años , Presión Intraocular/fisiología , Efusiones Coroideas/diagnóstico , Efusiones Coroideas/etiología , Glaucoma/cirugía , Glaucoma/fisiopatología , Glaucoma/complicaciones , Complicaciones Posoperatorias/diagnóstico , Microscopía Acústica , Estudios de Seguimiento , Trabeculectomía/efectos adversos , Trabeculectomía/métodos , Implantes de Drenaje de Glaucoma/efectos adversos , Agudeza Visual , Enfermedades de la Úvea/diagnóstico , Enfermedades de la Úvea/etiología , Tomografía de Coherencia Óptica/métodosRESUMEN
Os autores relatam a rara associação de efusão uveal e tuberculose ocular presumida em paciente do sexo masculino que apresentou melhora clínica com o uso sistêmico de prednisona 40 mg/d e rifampicina 600 mg/d. Descrevem, ainda, aspectos relevantes da efusão uveal, como etiopatogenia, evolução da doença, diagnóstico diferencial e tratamento, por meio de revisão da literatura.
The authors report a rare association of uveal effusion with presumed ocular tuberculosis in a male patient who presented clinical improvement with the systemic use of prednisone 40 mg/d and rifampicin 600 mg/d. In addition, relevant aspects of the uveal effusion such as the pathogenesis, evolution of the disease, differential diagnosis and treatment are described through a revision of the literature.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Exudados y Transudados , Tuberculosis Ocular/complicaciones , Enfermedades de la Úvea/etiología , Antibióticos Antituberculosos/uso terapéutico , Prednisona/uso terapéutico , Rifampin/uso terapéutico , Tuberculosis Ocular/tratamiento farmacológico , Enfermedades de la Úvea/patologíaRESUMEN
Os autores apresentam uma revisäo na literatura de Paracoccidioidomicose com comprometimento ocular