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We describe a 28-year-old Caucasian female with vigorexy, who had no previous ocular history. She presented with bilateral gradual painless reduction in vision over the past 3 weeks. She had been taking niacin supplements, averaging 500â¯mg daily, for 7 years. Fundus examination revealed bilateral CME, which was confirmed by ocular coherence tomography scan. Fundus fluorescein angiography did not reveal any fluid leakage. Niacin supplementation was discontinued, and after 2 months, the CME had completely resolved, and the best corrected visual acuities improved to 1 in both eyes.
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Langerhans cell histiocytosis (LCH) is a myeloid neoplasm characterized by clonal neoplastic proliferation of Langerhans-type dendritic cells associated with an inflammatory infiltrate predominantly composed of lymphocytes and eosinophils. In this article, we present an unusual case of LCH with significant swelling in the left lacrimal sac region in a 3-year-old child, clinically mimicking acute dacryocystitis. Microscopically, it showed intense inflammatory infiltrate and histiocytes with irregular nuclei. The tumor cells were positive for S-100 protein, CD1a, and CD207 (langerin). Molecular study was positive for the V600E/E2/D mutation (EXON 15). This case emphasizes the importance of careful clinical, radiographic, and microscopic evaluation, as some neoplasms may mimic common benign lesions.
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Sneddon's syndrome (SS) manifests through multiple strokes and livedo reticularis. Livedoid vasculopathy (VL) is characterized by a long history of foot and leg ulceration and histopathology indicating a thrombotic process. Arterial retinal branch occlusion is described in a 52-year-old male with VL. He did not present noticeable laboratory abnormalities, such as antiphospholipid antibodies, or a history of strokes. Retinal artery occlusion accompanied by VL could be a variant of Sneddon's syndrome. Optical coherence tomography angiography revealed a reduction in the macula's vascular layers in the asymptomatic eye, indicating localized microvascular changes as an evolving marker in the pathogenesis of SS.
Assuntos
Oclusão da Artéria Retiniana , Síndrome de Sneddon , Humanos , Masculino , Oclusão da Artéria Retiniana/etiologia , Oclusão da Artéria Retiniana/diagnóstico por imagem , Pessoa de Meia-Idade , Síndrome de Sneddon/complicações , Tomografia de Coerência Óptica , Livedo ReticularRESUMO
Aâ¯57-year-old woman with no premorbidities presented with symptoms of sudden painless vision loss in the right eye (RE). Best-corrected visual acuity in the RE was counting fingers to. A relative afferent pupillary defect was observed in the RE. Ocular fundus examination of RE was suggestive of central retinal artery occlusion. Systemic evaluation was normal. The most interesting fact in this case is that a hemorrhagic edema in the right glabellar region was the basis for the diagnostic suspicion. The patient recognized the loss of vision 24â¯h after hyaluronic acid injection as aâ¯facialâ¯rejuvenationâ¯treatment.
Assuntos
Ácido Hialurônico , Oclusão da Artéria Retiniana , Feminino , Humanos , Pessoa de Meia-Idade , Ácido Hialurônico/efeitos adversos , Oclusão da Artéria Retiniana/induzido quimicamente , Face , Injeções/efeitos adversos , Olho , Cegueira/induzido quimicamenteRESUMO
The case is presented of a girl diagnosed with obstructive hydrocephalus due to pilomyxoid astrocytoma, which required a ventriculoperitoneal shunt (VPS) at the age of 5 years and 10 months. Two months later, magnetic resonance imaging of the brain did not show ventriculomegaly or other signs of increased intracranial pressure. At the age of 6 years and 2 months, a rapid onset of bilateral visual acuity loss developed and she was diagnosed with slit ventricle syndrome. Despite valve revisions of the VPS, she developed an abrupt decline of visual acuity to hand motion at 10â¯cm. Fundus examination revealed bilateral optic atrophy. She did not report any other systemic symptoms suggesting increased intracranial pressure, such as headache, nausea, vomiting, lethargy, irritability, or altered levels of consciousness.
Assuntos
Doenças do Nervo Abducente , Hidrocefalia , Criança , Pré-Escolar , Feminino , Humanos , Hidrocefalia/cirurgia , Síndrome do Ventrículo Colabado/cirurgia , Derivação Ventriculoperitoneal , Acuidade VisualRESUMO
The case is presented of a girl diagnosed with obstructive hydrocephalus due to pilomyxoid astrocytoma, which required a ventriculoperitoneal shunt (VPS) at the age of 5 years and 10 months. Two months later, magnetic resonance imaging of the brain did not show ventriculomegaly or other signs of increased intracranial pressure. At the age of 6 years and 2 months, a rapid onset of bilateral visual acuity loss developed and she was diagnosed with slit ventricle syndrome. Despite valve revisions of the VPS, she developed an abrupt decline of visual acuity to hand motion at 10cm. Fundus examination revealed bilateral optic atrophy. She did not report any other systemic symptoms suggesting increased intracranial pressure, such as headache, nausea, vomiting, lethargy, irritability, or altered levels of consciousness.
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"Ankyloblepharon filiforme adnatum" is a congenital anomaly characterized by partial or complete adhesion of upper and lower eyelids. The lid margins remain fused until the end of the fifth month of gestational age. Complete separation usually is completed about the seventh fetal month. Ankyloblepharon may be an isolated manifestation or may be associated with abnormalities in other organs and / or systems. The case is presented on a newborn male with family history of hypohydrotic ectodermal dysplasia (mother and maternal grandfather). It revealed extensible bands of skin in right and in left eye. Apart from this, he presented cleft lip, complete absence of palate, nail and ungueal dysplasia and supernumerary nipples.
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Retinal pattern dystrophies are a heterogeneous group of generally bilateral and symmetrical maculopathies that, curiously, can be associated with different systemic diseases. This article describes a patient with unilateral pattern dystrophies, as well as associated McArdle disease and idiopathic pulmonary fibrosis.
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We present a case of bilateral and multifocal central serous chorioretinopathy that developed one month after an intra-chalazion triamcinolone acetonide injection. Central serous chorioretinopathy spontaneously resolved during observation 3 months after diagnosis. We believe that central serous chorioretinopathy can occur as a complication of administration of depot corticosteroids even at a low dose.
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Coriorretinopatia Serosa Central/induzido quimicamente , Calázio/tratamento farmacológico , Glucocorticoides/efeitos adversos , Triancinolona Acetonida/efeitos adversos , Coriorretinopatia Serosa Central/patologia , Glucocorticoides/administração & dosagem , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Triancinolona Acetonida/administração & dosagemAssuntos
Abuso de Maconha/complicações , Psicoses Induzidas por Substâncias/complicações , Transtornos da Visão/etiologia , Vias Visuais/fisiopatologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Abuso de Maconha/fisiopatologia , Neuroimagem , Nervo Óptico/diagnóstico por imagem , Nervo Óptico/patologia , Psicoses Induzidas por Substâncias/fisiopatologia , Tálamo/diagnóstico por imagem , Tálamo/patologia , Transtornos da Visão/diagnóstico por imagem , Vias Visuais/diagnóstico por imagem , Percepção Visual , Adulto JovemRESUMO
CLINICAL CASE: An uncommon case is presented of a 15 year-old girl with bilateral, multiple serous detachments of retina and retinal pigment epithelium. With clinical and laboratory (IgG 1/160 and IgM 1/160, using an indirect immunofluorescence assay) diagnoses of leptospirosis, a complete ophthalmic examination, fluorescein angiography, autofluorescence and optical coherence tomography were performed, and the patient was followed for two years. DISCUSSION: Bilateral, multiple serous detachments of retina and retinal pigment epithelium can be a complication of systemic leptospirosis, a zoonotic disease caused by Leptospira. Without a detailed medical history it may be underdiagnosed, mainly because it can mimic other more common diseases. It may be prudent to ask patients regarding contact with pets.
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Leptospirose/complicações , Descolamento Retiniano/microbiologia , Epitélio Pigmentado da Retina , Adolescente , Feminino , Humanos , RetinaAssuntos
Coriorretinite/diagnóstico por imagem , Sífilis/diagnóstico por imagem , Coriorretinite/terapia , Tratamento Conservador , Angiofluoresceinografia , Fundo de Olho , Humanos , Imagem Óptica , Epitélio Pigmentado da Retina/diagnóstico por imagem , Epitélio Pigmentado da Retina/patologia , Sífilis/terapia , Tomografia de Coerência ÓpticaRESUMO
CLINICAL CASE: The case is presented of a 73-year-old male patient who referred to having black and white vision. Computed tomography showed normal pressure hydrocephalus (NPH). Magnetic resonance imaging was not performed because the patient refused to undergo further examinations. DISCUSSION: Achromatopsia may be the first or only NPH symptom. It may be prudent to ask patients with NPH regarding colour vision.
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Defeitos da Visão Cromática/etiologia , Hidrocefalia de Pressão Normal/complicações , Hidrocefalia de Pressão Normal/diagnóstico , Idoso , Humanos , MasculinoRESUMO
INTRODUCTION: Adalimumab, an anti-tumour necrosis factor alpha therapy for active Crohn's disease (CD), is associated with increased risks of tuberculosis infection. CASE REPORT: The case is presented of a 48 year-old male with active CD on treatment with adalimumab. After three months, he developed a miliary pulmonary tuberculosis infection, with a solitary non-reactive choroidal tubercle temporal-superior to the optic disc being found in an ophthalmological study. Fluorescein angiography showed late hyperfluorescence in a staining pattern. Optic coherence tomography showed a flat mass without serous retinal detachment. The choroidal tubercle slowly regressed with antituberculosis therapy. DISCUSSION: Choroidal tubercles with no vitreo-retinal symptomatology can be present in patients with CD and on treatment with adalimumab.
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Adalimumab/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Doenças da Coroide/induzido quimicamente , Doença de Crohn/tratamento farmacológico , Tuberculose Ocular/induzido quimicamente , Adalimumab/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Doenças Assintomáticas , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Presumed solitary circumscribed retinal astrocytic proliferation (PSCRAP) is a small defined solitary lesion. CASE REPORT: A 58-year-old man had an opaque yellow retinal lesion inferonasal to the optic disc. Fluorescein angiography showed mild early hyperfluorescence and late fluorescence. Ultrasound showed no calcification. Autofluorescence disclosed moderate hyperautofluorescence. Optical coherence tomography showed the mass with a snowball configuration and a smooth surface. More than one year later, the lesion was unchanged. DISCUSSION: PSCRAP is a benign stable lesion. The main importance lies in its differentiation from well-circumscribed yellow-white lesions of the retina.