RESUMO
We designed and built a homemade computed tomography imaging spectrometer (CTIS) of 250×250pixels of spatial resolution and 2 nm spectral resolution. The optical design considers a CTIS optical array coupled to a digital reflex camera. We reconstructed the intensity spectra of a fluorescent source, the diffuse reflectance of a ColorChecker, and samples of Capsicum annuum of three different colors, using the expectation-maximization sequential algorithm, optimized utilizing an array of indices to reduce the reconstruction time. The results obtained with a ColorChecker indicate a high positive correlation of 0.9745 with an average residual difference of 1.31% concerning the spectra obtained with a commercial integrating sphere spectrometer. The feasibility of the proposed CTIS system shows how to detect and evaluate the physiological changes resulting from the decomposition of the green fruit of the Capsicum annuum in a range from 500 to 650 nm.
Assuntos
Algoritmos , Motivação , Tomografia Computadorizada por Raios X/métodosAssuntos
Neovascularização de Coroide , Papiledema , Pseudotumor Cerebral , Feminino , Angiofluoresceinografia , Humanos , GravidezRESUMO
A presentation is made of two cases of acute zonal occult outer retinopathy (AZOOR); one a young man of 19 years, and the other a 42-year-old woman. The young man complained of unilateral scotoma and photopsia. The woman presented with bilateral visual loss and photopsia. Multimodal imaging, including fundus photography, fluorescein angiography, fundus autofluorescence, spectral-domain optical coherence tomography, and visual field testing, supported the diagnosis of AZOOR. The differential diagnosis is complicated, since it has clinical features in common with other retinopathies. This means that it is essential to use modern imaging tests, especially those where the characteristic trizonal pattern is shown, such as in autofluorescence and OCT.
Assuntos
Escotoma , Síndrome dos Pontos Brancos , Adulto , Feminino , Angiofluoresceinografia , Humanos , Masculino , Escotoma/diagnóstico , Acuidade Visual , Adulto JovemRESUMO
A 36 year-old woman with idiopathic intracranial hypertension was treated with topiramate and acetazolamide. The patient was followed-up for 2 years, with a relationship between neurosensory detachments and topiramate being established, with recurrences after the introduction of topiramato and improvement after its withdrawal. These findings point topiramate as a possible cause of the clinical picture. Topiramate may cause retinal and macular neurosensory detachments. Although the ciliochoroidal effusion cases caused by this drug are well-known, its retinal side effects are less common. As it is a widely used drug, neurologists and ophthalmologists should be aware of its possible ocular side effects.
Assuntos
Anti-Hipertensivos/efeitos adversos , Macula Lutea , Descolamento Retiniano/induzido quimicamente , Topiramato/efeitos adversos , Acetazolamida/uso terapêutico , Adulto , Anti-Hipertensivos/uso terapêutico , Feminino , Fundo de Olho , Humanos , Hipertensão Intracraniana/tratamento farmacológico , Recidiva , Tomografia de Coerência ÓpticaRESUMO
Macular involvement is a common finding in patients with Eales disease. The purpose of this communication is to describe the diagnosis of Eales disease from the finding of a macular epiretinal membrane in a young patient. The case is presented of a 38-year-old man referred to this medical service unit with blurred vision developed over the past 3 months, and was associated with vitreoretinal traction and a macular epiretinal membrane. After an ophthalmological examination including the retinal periphery, optical coherence tomography, tuberculin test, interferon gamma release assay (IGRA), and a systemic study, the patient was diagnosed with Eales disease. Macular oedema or epiretinal membranes due to Eales disease are relatively common. Sd-OCT is recommended in all patients with Eales disease. On the other hand, the presence of epiretinal membranes in young patients usually suggests a non-idiopathic aetiology.
Assuntos
Membrana Epirretiniana/etiologia , Neovascularização Patológica/complicações , Neovascularização Patológica/diagnóstico , Vasculite Retiniana/complicações , Vasculite Retiniana/diagnóstico , Adulto , Membrana Epirretiniana/diagnóstico por imagem , Angiofluoresceinografia , Humanos , Masculino , Tomografia de Coerência Óptica , Acuidade VisualRESUMO
The case is presented of a 32 year-old male who arrived with acute bilateral symptoms with blurred vision, red eye, severe photophobia and severe ocular pain after suffering from a flu-like syndrome. The patient presented with a clinical picture of bilateral involvement characterised by pupils in mid-mydriasis, scarcely reactive to light, iris transillumination, diffuse depigmentation of the iridian stroma, pigment dispersion in the anterior chamber, and ocular hypertension. After the eye examination an inflammatory syndrome and pigmentary glaucoma were ruled out. The patient showed depigmentation characteristics as well as bilateral iris transillumination. Both conditions could form part of the spectrum of the same disease.
Assuntos
Doenças da Íris/diagnóstico , Doença Aguda , Adulto , Anti-Hipertensivos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Endotélio Corneano/patologia , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Iridociclite/diagnóstico , Doenças da Íris/tratamento farmacológico , Doenças da Íris/etiologia , Masculino , Midríase/etiologia , Hipertensão Ocular/complicações , Pan-Uveíte/complicações , Pigmentos Biológicos/análise , Prednisolona/uso terapêutico , Lâmpada de Fenda , Síndrome , TransiluminaçãoRESUMO
A 30 year-old man with acute myeloblastic leukaemia and secondary myelodysplastic syndrome developed graft-versus-host disease. The patient was treated with ruxolitinib. After being treated for 3 months with ruxolitinib, an inhibitor of Janus kinase, he developed Aspergillus retinal necrosis resistant to common treatment. Treatment with Janus kinase inhibitors may lead to an increased incidence of opportunistic infections. Janus kinase inhibitor administration may result in poor treatment efficacy.
Assuntos
Aspergilose/complicações , Infecções Oculares Fúngicas/microbiologia , Pirazóis/efeitos adversos , Retina/patologia , Adulto , Aspergilose/tratamento farmacológico , Aspergillus flavus/isolamento & purificação , Aspergillus niger/isolamento & purificação , Evolução Fatal , Doença Enxerto-Hospedeiro/tratamento farmacológico , Humanos , Isquemia/diagnóstico por imagem , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Síndromes Mielodisplásicas/etiologia , Necrose/microbiologia , Nitrilas , Infecções Oportunistas/microbiologia , Pirimidinas , Vasos Retinianos/diagnóstico por imagemRESUMO
CASE REPORT: The case is reported of a 61 year-old woman with Purtscher-like retinopathy associated with acute renal failure. Ophthalmic examination, fluorescein-angiography, and optical coherence tomography were consistent with Purtscher-like retinopathy. Ophthalmic symptoms and signs preceded renal failure. Pancreatitis and other systemic diseases were ruled out. The patient developed a neovascular glaucoma. DISCUSSION: Purtscher-like retinopathy rarely precedes the associated systemic illness. Early diagnosis based on ophthalmic symptoms may help in the recognition and treatment of the disease, and prevent later complications.
Assuntos
Injúria Renal Aguda/complicações , Cegueira/complicações , Doenças Retinianas/complicações , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
CASE REPORT: The case is presented of a 32 year-old male with no medical history of interest who suffered a traffic accident with mild traumatic brain injury. He had a left supraciliary incised and contused wound that extended to the left upper eyelid, with no loss of vision. After palpebral anaesthetic injection, there was a sudden visual acuity decrease in the left eye and hyposphagma located between I-III at 4mm from the limbus, with increased intraocular pressure. A whitish lesion with a central haemorrhagic focus was observed in the ocular fundus, corresponding to the area where the hyposphagma was located. DISCUSSION: Anaesthetic injection during palpebral repair may be complicated by inadvertent penetration of the eyeball. Intravitreal mepivacaine and adrenaline could cause macular and retinal lesions.
Assuntos
Anestésicos Locais/administração & dosagem , Anestésicos Locais/toxicidade , Epinefrina/administração & dosagem , Epinefrina/efeitos adversos , Erros de Medicação , Mepivacaína/administração & dosagem , Mepivacaína/efeitos adversos , Doenças Retinianas/induzido quimicamente , Adulto , Humanos , Injeções Intravítreas , MasculinoRESUMO
CASE REPORT: Two cases of tubulointerstitial nephritis and uveitis are presented. Immunosuppressive therapy was required to control the uveitis. Contrary to that usually described, uveitis became chronic, which made immunosuppressive therapy necessary. Nephritis was successfully treated with steroids. DISCUSSION: Tubulointerstitial nephritis and uveitis syndrome is an under-diagnosed disorder and requires clinical suspicion due to there being no specific laboratory study available. Recurrences and relapses of ocular inflammation are common. Immunosuppressive therapy is not often needed.
Assuntos
Terapia de Imunossupressão , Nefrite Intersticial/tratamento farmacológico , Uveíte/tratamento farmacológico , Adolescente , Adulto , Feminino , HumanosRESUMO
CASE REPORT: The case is presented of a 45 year-old man with a focal choroidal excavation associated with choroidal neovascularisation not included in the area of excavation. Clinical features were analysed using retinography, fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography. The patient was treated with 3 intravitreal injections of bevacizumab, with a good response. DISCUSSION: Focal choroidal excavation can be associated with choroidal neovascularization not included in the area of excavation. Multimodal imaging provides a complete description of clinical features, before and after treatment.
Assuntos
Doenças da Coroide/complicações , Neovascularização de Coroide/complicações , Doenças da Coroide/diagnóstico por imagem , Neovascularização de Coroide/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
CASE REPORT: The case is presented on a 54-year-old woman with a central serous chorioretinopathy, misdiagnosed as Vogt-Koyanagi-Harada disease, and treated with systemic corticosteroids. The patient presented with a bilateral bullous exudative retinal detachment. DISCUSSION: Discontinuation of corticosteroid therapy, surgical drainage of subretinal fluid, and photodynamic therapy, led to anatomical and functional improvement. The recognition of an atypical presentation of central serous chorioretinopathy may avoid complications of the inappropriate treatment with corticosteroids.
Assuntos
Corticosteroides/efeitos adversos , Coriorretinopatia Serosa Central/complicações , Descolamento Retiniano/etiologia , Corticosteroides/uso terapêutico , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/tratamento farmacológico , Erros de Diagnóstico , Drenagem , Feminino , Humanos , Pessoa de Meia-Idade , Descolamento Retiniano/cirurgia , Síndrome Uveomeningoencefálica/diagnósticoRESUMO
CASE REPORT: The case is presented of a 42 year-old man with episodes of unilateral uveitis in his right eye. Ophthalmic examination showed a granulomatous anterior uveitis with vitritis. Systemic investigations revealed non-nephrotic proteinuria and microhaematuria. A renal biopsy showed IgA nephropathy. DISCUSSION: Uveitis and glomerulonephritis may have common immunological pathogenesis. IgA nephropathy should be a differential diagnosis in patients with uveitis and nephropathy.
Assuntos
Glomerulonefrite por IGA/complicações , Uveíte/etiologia , Adulto , Humanos , Masculino , Uveíte/diagnóstico por imagemRESUMO
CASE REPORT: The case is presented of a 39 year-old man with a combined hamartoma of the retina and retinal pigment epithelium, who experienced progressive visual loss and worsening of metamorphopsia. The patient underwent vitrectomy and epiretinal component peeling, with improvement in visual acuity, metamorphopsia, and retinal architecture, assessed by optical coherence tomography. DISCUSSION: Selected patients with combined hamartomas of the retina and retinal pigment epithelium may beneï¬t from surgical management.
Assuntos
Hamartoma/cirurgia , Doenças Retinianas/cirurgia , Epitélio Pigmentado da Retina/cirurgia , Vitrectomia/métodos , Adulto , Angiofluoresceinografia , Hamartoma/diagnóstico por imagem , Humanos , Masculino , Doenças Retinianas/diagnóstico por imagem , Epitélio Pigmentado da Retina/diagnóstico por imagem , Tomografia de Coerência ÓpticaRESUMO
CASE REPORT: A 47 year-old woman with a choroidal melanoma developed a macular oedema secondary to radiation therapy 75 months after brachytherapy plaque. The patient received 3 intravitreal Bevacizumab injections. DISCUSSION: The patient had a good response to bevacizumab treatment. In fact, there was a reduction in the macular oedema measured by optical coherence tomography (OCT) scan, as well as an improvement in best corrected visual acuity. There was no recurrence of macular oedema, and visual acuity remained stable after 3-years follow-up.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Braquiterapia/efeitos adversos , Neoplasias da Coroide/radioterapia , Edema Macular/tratamento farmacológico , Melanoma/radioterapia , Lesões por Radiação/tratamento farmacológico , Inibidores da Angiogênese/administração & dosagem , Bevacizumab/administração & dosagem , Hemorragia da Coroide/etiologia , Feminino , Angiofluoresceinografia , Humanos , Injeções Intravítreas , Implante de Lente Intraocular , Edema Macular/diagnóstico por imagem , Edema Macular/etiologia , Pessoa de Meia-Idade , Facoemulsificação , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/etiologia , Tomografia de Coerência ÓpticaRESUMO
CASE REPORT: We present the case of a 69-year-old woman with unilateral retinal vasculitis. Investigations showed asthma, rhinosinusitis, nasal polyposis, peripheral blood eosinophilia, increased sedimentation rate, proteinuria, and antiphospholipid antibodies. Anti-neutrophil cytoplasmic antibodies (ANCA) were negative. DISCUSSION: Although her anti-neutrophil cytoplasmatic antibody (ANCA) status was negative, taking into account the other clinical and laboratory features, retinal vasculitis was thought to be an ocular manifestation of Churg-Strauss syndrome. Treatment was started with high-dose corticosteroids and anticoagulant therapy.
Assuntos
Anticorpos Antifosfolipídeos/sangue , Síndrome de Churg-Strauss/complicações , Vasculite Retiniana/etiologia , Idoso , Asma/etiologia , Síndrome de Churg-Strauss/sangue , Síndrome de Churg-Strauss/tratamento farmacológico , Síndrome de Churg-Strauss/imunologia , Colite Isquêmica/etiologia , Eosinofilia/etiologia , Feminino , Angiofluoresceinografia , Humanos , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Fotocoagulação a Laser , Edema Macular/etiologia , Edema Macular/cirurgia , Neurite (Inflamação)/etiologia , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/cirurgia , Vasculite Retiniana/diagnóstico por imagemRESUMO
CASE REPORT: The first case is described on a patient with Urrets-Zavalía syndrome after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in whom an ExPRESS implant was used. DISCUSSION: The ExPRESS implant is a useful tool for complex cases of post-surgical glaucoma where patients need to avoid post-operative inflammation and risks (corneal transplant patients). It is also very useful in cases with a high risk of fibrosis due to previous interventions.
Assuntos
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos , Implantes para Drenagem de Glaucoma , Glaucoma/cirurgia , Midríase/cirurgia , Complicações Pós-Operatórias/cirurgia , Ar , Resistência a Medicamentos , Distrofia Endotelial de Fuchs/cirurgia , Glaucoma/etiologia , Humanos , Complicações Intraoperatórias/etiologia , Iris/irrigação sanguínea , Isquemia/etiologia , Pessoa de Meia-Idade , Midríase/etiologia , Pilocarpina/uso terapêutico , Complicações Pós-Operatórias/etiologia , Pressão/efeitos adversosRESUMO
CASE REPORT: A 61-year-old pseudophakic male with recurrent blurred vision episodes associated with uveitis, hyphema, glaucoma and vitreous hemorrhage. Iris transillumination defects and apposition of the optic and iris were found. The patient was diagnosed with Uveitis-Glaucoma-Hyphema (UGH) Syndrome. DISCUSSION: Mechanical irritation of the iris is a consequence of intraocular lens malposition and causes UGH Syndrome. Occasionally it is associated with vitreous hemorrhage. Lens malposition is detected by optical coherence tomography and/or ultrasound biomicroscopy.