RESUMO
Orbital inflammatory disease (OID), commonly known as orbital pseudotumour, is an inflammatory disease of unknown cause. It has different forms of presentation and different degrees of severity. Its variable nature is the main cause for this disease to be misdiagnosed and misclassified. The prognosis of OID depends on the tissues affected and the histology. OID usually responds favourably to systemic steroid treatment. However, empiric steroids may mask other underlying diseases that respond well to this treatment as well, namely, IgG4-related disease or lymphoproliferative disorders. This fact has led to controversy among various authors as some recommend performing a biopsy in most of the cases, whereas others defend that this procedure should only be performed if the patient has not responded to empiric steroid treatment. Although steroids have been the mainstream treatment of OID, the side effects, relapse rates and lack of response in some cases have resulted in them being replaced by immunosuppressive and immunomodulator therapies that currently stand as a key steroid-sparing treatment option, in addition to radiotherapy and surgery. The aim of this review is to update the evidence on the diagnosis and treatment of OID.
Assuntos
Doença Relacionada a Imunoglobulina G4 , Doenças Orbitárias , Pseudotumor Orbitário , Biópsia , Humanos , Imunossupressores/uso terapêutico , Pseudotumor Orbitário/diagnóstico , Pseudotumor Orbitário/tratamento farmacológicoAssuntos
Melanoma , Midríase , Neoplasias Cutâneas , Protocolos de Quimioterapia Combinada Antineoplásica , Humanos , Ipilimumab/efeitos adversos , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Nivolumabe/efeitos adversos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Melanoma Maligno CutâneoRESUMO
Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency is a rare metabolic disease caused by a specific mutation in the HADHA gene, which leads to an alteration in the metabolic pathway of fatty acids. Its most frequent form of presentation at the ophthalmological level is retinitis pigmentosa, and in some cases the ophthalmologist could be the first one to alert the other paediatric specialties to carry out a multidisciplinary approach to the case. The case is presented of a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficit detected in neonatal screening, and which clinically debuted as pigmentary retinosis with no alteration in visual acuity as observed in the fundus images and optical coherence tomography of the retina provided. Finally, a review of the literature of this potentially lethal pathology is presented, and the main pathological and clinical features are highlighted.
Assuntos
Miopatias Mitocondriais , Doenças do Sistema Nervoso , Retinose Pigmentar , 3-Hidroxiacil-CoA Desidrogenases , Cardiomiopatias , Criança , Humanos , Recém-Nascido , Erros Inatos do Metabolismo Lipídico , Proteína Mitocondrial Trifuncional/deficiência , Retinose Pigmentar/diagnóstico , RabdomióliseRESUMO
Haberland syndrome or encephalocutaneous lipomatosis is a very uncommon syndrome that is characterised by changes in the skin, eye, and central nervous system. It was first described in 1970 by Haberland and Perou, with about 60 cases having been reported since then. A case is reported of a 14-week-old male diagnosed with Haberland syndrome with bilateral ocular involvement in the form of palpebral coloboma and choristomas.
Assuntos
Doenças do Nervo Óptico , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , RecidivaRESUMO
We report a case of a patient treated with tamoxifen 20mg daily as hormone therapy for breast cancer. On regular ophthalmological follow-up, tamoxifen maculopathy was detected on SD-OCT (Spectral Domain Optic Coherence Tomography, Carl Zeiss Meditec®), so the medication was discontinued. Despite discontinuation of the medication, the maculopathy progressed over time. We have been following our patient for seven years. Tamoxifen may produce a toxic maculopathy which may progress despite discontinuation of the medication. We consider our case interesting, given the lengthy follow-up of the patient with sequential SD-OCT images. To the best of our knowledge, our case represents the longest follow-up period for a patient with tamoxifen maculopathy. Moreover, we would like to stress the importance of screening in asymptomatic patients on this medication, in order to detect early pathological signs.
Assuntos
Monitorização Fisiológica , Doenças Retinianas/induzido quimicamente , Doenças Retinianas/diagnóstico , Tamoxifeno/efeitos adversos , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Macula Lutea/efeitos dos fármacos , Macula Lutea/patologia , Degeneração Macular/induzido quimicamente , Degeneração Macular/diagnóstico , Degeneração Macular/patologia , Monitorização Fisiológica/métodos , Doenças Retinianas/patologia , Tamoxifeno/administração & dosagem , Tomografia de Coerência ÓpticaAssuntos
Betacoronavirus , Infecções por Coronavirus , Emergências , Pandemias , Pneumonia Viral , COVID-19 , Humanos , SARS-CoV-2Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Doenças Profissionais/prevenção & controle , Oftalmologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , COVID-19 , Infecções por Coronavirus/epidemiologia , Desinfecção , Humanos , Higiene , Doenças Profissionais/epidemiologia , Oftalmologia/instrumentação , Pneumonia Viral/epidemiologia , SARS-CoV-2Assuntos
Anoftalmia/cirurgia , Olho Artificial , Autocuidado , Medicina Baseada em Evidências , HumanosRESUMO
Intraorbital Foreign Bodies (IOFB) are objects, usually of metallic nature, located outside the orbit cavity, and can potentially cause serious damage to ocular and orbital structures. The case is presented of a patient with an anterior metallic IOFB that was extracted with the aid of a Livingston-Mansfield ocular external electromagnet. Despite being an instrument «of the past¼, we believe that the electromagnet can still be useful in certain circumstances.