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1.
World J Clin Cases ; 11(19): 4635-4639, 2023 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-37469722

RESUMO

BACKGROUND: Congenital glaucoma associated with Roberts syndrome (RS) is an unusual and unique condition. No previous report describes this association. A multidisciplinary approach including molecular studies were conducted to reach the final diagnosis. CASE SUMMARY: We present a rare case of a 1-wk-old male with RS associated with bilateral congenital glaucoma, left ectopic kidney, and left-hand rudimentary digits. A comprehensive approach was applied by which bilateral non-penetrating glaucoma surgery was performed with good control of intraocular pressure for more than 6 mo. Cytogenetic and molecular testing were conducted and revealed normal measurements. CONCLUSION: This report described a case of a male baby with clinical features of RS but with a negative molecular analysis, presenting with left-hand rudimentary digits, bilateral congenital glaucoma, and left ectopic kidney. To the best of our knowledge, this is the first case reported with phocomelia, bilateral congenital glaucoma, and unilateral ectopic kidney.

2.
Middle East Afr J Ophthalmol ; 29(2): 100-102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-37123425

RESUMO

We present the rare case of an 18-year-old medically free male who had a history of decrease in vision in the left eye (LE) in the last 4 years. On examination, best-corrected visual acuity was 20/20 in the right eye (RE) and counting fingers 3 feet in the LE. Intraocular pressure was 34 and 40 mmHg in RE and LE, respectively. Fundus examination showed cupping of 0.7 on the RE and 0.9 on the LE. Gonioscopy revealed bilateral angle closure with a double-hump sign. Ultrasound biomicroscopy showed multiple ciliary body cysts replacing ciliary body sulcus space bilaterally.


Assuntos
Cistos , Glaucoma de Ângulo Fechado , Doenças da Íris , Humanos , Masculino , Adolescente , Corpo Ciliar , Glaucoma de Ângulo Fechado/complicações , Glaucoma de Ângulo Fechado/diagnóstico , Doenças da Íris/diagnóstico , Pressão Intraocular , Microscopia Acústica , Cistos/complicações , Cistos/diagnóstico , Gonioscopia
3.
Middle East Afr J Ophthalmol ; 28(3): 184-188, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35125802

RESUMO

Deep anterior lamellar keratoplasty (DALK) is a surgical intervention for corneal diseases that do not affect the endothelium. The creation of an interface between the donor graft and recipient bed is a typical feature of DALK. Interface infectious keratitis (IIK) is an uncommon complication that originates at this point of contact. The onset of IIK following lamellar keratoplasty can cause delayed visual loss and subsequent endophthalmitis, with primarily fungal etiology (e.g., Candida spp.) and occasionally bacterial etiology. Infection of the lamellar interface may be attributed to contamination of the donor material or to precipitating factors such as loose sutures, persistent epithelial defects, and prolonged topical steroid use; fungal IIK is frequently resistant to medical treatment. Here, we describe the previously unreported occurrence of corneal perforation as a complication of fungal IIK after DALK. A 26-year-old otherwise healthy woman underwent uneventful DALK for advanced keratoconus in the left eye. She was discharged with instructions to apply topical prednisolone acetate and topical moxifloxacin. Culture of the donor corneoscleral rim showed growth of Candida glabrata, although the patient exhibited no clinical signs of infection. Approximately 3 months later, the patient exhibited mild blurring of vision in her left eye. Therefore, treatment was modified to topical amphotericin B and oral voriconazole. One week later, the patient developed multiple, sheath-like whitish creamy infiltrates, primarily in the lamellar interface; a positive Seidel test result indicated the presence of corneal perforation. As treatment for IIK, excisional penetrating keratoplasty (PK) was performed, followed by topical amphotericin B and topical prednisolone acetate treatment. During 12 months of follow-up after PK, the corneal graft was clear and there was no clinical evidence of recurrent keratitis. Prompt excisional PK prevented the progression of IIK to endophthalmitis in our patient. Early intervention with excisional PK should be considered when a diagnosis of fungal IIK is suspected in a patient with a positive donor rim culture, and in whom the condition does not respond to medical treatment. This early intervention is essential to prevent delayed treatment, which could result in corneal perforation and endophthalmitis, with ultimately poor visual outcomes.


Assuntos
Perfuração da Córnea , Transplante de Córnea , Ceratite , Ceratocone , Adulto , Perfuração da Córnea/etiologia , Perfuração da Córnea/cirurgia , Feminino , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Ceratite/etiologia , Ceratocone/cirurgia , Ceratoplastia Penetrante
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