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1.
Turk J Ophthalmol ; 54(5): 275-281, 2024 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-39463164

RESUMO

Objectives: To evaluate the anatomical and visual outcomes of the multilayered inverted internal limiting membrane (ML-ILM) flap technique in the treatment of optic disc pit maculopathy (ODPM). Materials and Methods: In this retrospective interventional case series, medical records and macular spectral-domain optical coherence tomography images of patients who underwent combined pars plana vitrectomy with ML-ILM flap surgery for ODPM were analyzed. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) at postoperative 6 months were compared with baseline findings. Intraoperative and postoperative complications, fluid resolution time, and recurrence during follow-up were recorded. Results: Five eyes of 5 patients with ODPM were included in the study. According to the preoperative macular fluid characteristics, 2 patients had only intraretinal fluid, while 3 patients had intraretinal and subretinal fluid. The preoperative median BCVA was 1.0 logarithm of the minimum angle of resolution (logMAR) (range, 1.0-1.3 logMAR), and the CMT was 560 µm (range, 452-667 µm). At the 6-month postoperative follow-up, the median BCVA was 0.40 logMAR (range, 0.1-0.7 logMAR), and CMT was 315 µm (range, 265-326 µm) (p=0.042 and p=0.043, respectively). During the 6-month follow-up period, no recurrence or full-thickness macular hole formation was observed. Conclusion: The ML-ILM flap technique is a preferable surgical option to achieve both high anatomical and functional success and flap stabilization.


Assuntos
Membrana Basal , Disco Óptico , Retalhos Cirúrgicos , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia , Humanos , Estudos Retrospectivos , Disco Óptico/anormalidades , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos , Adulto , Membrana Basal/cirurgia , Seguimentos , Anormalidades do Olho/cirurgia , Anormalidades do Olho/diagnóstico , Adulto Jovem , Doenças Retinianas/cirurgia , Doenças Retinianas/diagnóstico , Adolescente , Pessoa de Meia-Idade , Macula Lutea/patologia
2.
BMC Ophthalmol ; 24(1): 432, 2024 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-39367398

RESUMO

BACKGROUND: Congenital optic disc pit (ODP) is a relatively uncommon congenital anomaly of the optic disc, which seriously affects the patient's vision when combined with optic disc pit maculopathy(ODP-M). Currently, the treatment of ODP-M remains a clinical challenge and a focus of research. CASE PRESENTATION: A boy had a pit in the inferotemporal segment of the optic disc with ODP-M. Optical Coherence Tomography(OCT) showed ODP and serous retinal detachment. He was treated with pars plana vitrectomy(PPV), followed by Corneal Stromal Lenticule (CSL) sealing and C3F8 tamponade. In the end, significant anatomical improvement was achieved, and the Best Corrected Visual Acuity(BCVA) was improved. CONCLUSIONS: The CSL transplantation may be a viable therapeutic option for improving ODP-M with stable anatomical and functional result. However, more cases and longer follow-up are needed to confirm the safety and effectiveness of the technology.


Assuntos
Substância Própria , Disco Óptico , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Masculino , Disco Óptico/anormalidades , Substância Própria/cirurgia , Substância Própria/transplante , Anormalidades do Olho/cirurgia , Descolamento Retiniano/cirurgia , Descolamento Retiniano/diagnóstico , Vitrectomia/métodos , Doenças Retinianas/cirurgia , Doenças Retinianas/congênito , Doenças Retinianas/diagnóstico
3.
Ophthalmic Plast Reconstr Surg ; 40(5): e174-e176, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39240207

RESUMO

Complex congenital lacrimal drainage anomalies are known to be associated with several syndromes and present unique surgical challenges. Duplication of human body structures is uncommon and has been reported in the uterus (uterine didelphys), ureter (duplex ureter), duodenum, transverse colon, and nose. Lacrimal drainage anomalies have been reported in proboscis lateralis. To the best of the authors' knowledge, there are no prior reports on duplication of the lacrimal sac. The present case reports a complex congenital nasolacrimal duct obstruction that was associated with duplication of the lacrimal sac and the presence of 3 canaliculi.


Assuntos
Ducto Nasolacrimal , Humanos , Ducto Nasolacrimal/anormalidades , Ducto Nasolacrimal/cirurgia , Feminino , Obstrução dos Ductos Lacrimais/congênito , Obstrução dos Ductos Lacrimais/diagnóstico , Dacriocistorinostomia/métodos , Aparelho Lacrimal/anormalidades , Aparelho Lacrimal/cirurgia , Aparelho Lacrimal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia
4.
Ophthalmic Plast Reconstr Surg ; 40(4): e125-e128, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38967579

RESUMO

Ablepharon-macrostomia syndrome is a rare disorder characterized by TWIST2 mutations and anterior lamellar dysgenesis. Timely intervention is critical to prevent exposure keratopathy, corneal ulceration, and permanent vision loss. We report a novel approach to multiplanar eyelid reconstruction in ablepharon-macrostomia syndrome involving use of a modified reverse hatchet flap in 1 lower eyelid along with division at the eyelid margin, recession of the eyelid retractors in conjunction with preputial skin grafting for anterior lamellar restoration in the other 3 eyelids.


Assuntos
Blefaroplastia , Anormalidades do Olho , Pálpebras , Macrostomia , Retalhos Cirúrgicos , Humanos , Macrostomia/cirurgia , Pálpebras/cirurgia , Pálpebras/anormalidades , Anormalidades do Olho/cirurgia , Blefaroplastia/métodos , Masculino , Anormalidades Múltiplas/cirurgia , Feminino , Procedimentos de Cirurgia Plástica/métodos
5.
Childs Nerv Syst ; 40(7): 2161-2168, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38459147

RESUMO

INTRODUCTION: Meckel-Gruber Syndrome (MKS) is an autosomal recessive genetic disorder, notable for its triad of occipital encephalocele, polycystic renal dysplasia, and postaxial polydactyly. Identified by Johann Friederich Meckel in 1822, MKS is categorized as a ciliopathy due to gene mutations. Diagnosis is confirmed by the presence of at least two key features. The condition is incompatible with life, leading to death in the womb or shortly after birth. Recent studies have largely focused on the genetic aspects of MKS, with limited information regarding the impact of neurosurgical approaches, particularly in treating encephaloceles. METHODS: A systematic review was performed according to the PRISMA statement. The PubMed, Embase, and Web of Science databases were consulted for data screening and extraction, which was conducted by two independent reviewers. The search strategy aimed to encompass studies documenting cases of MKS with published reports of encephalocele excisions, and the search strings for all databases were: Meckel-Gruber syndrome OR Meckel Gruber syndrome OR Meckel-gruber OR Meckel Gruber. RESULTS: The study included 10 newborns with MKS associated with occipital encephalocele or meningocele, all of whom underwent surgical repair of the occipital sac. The mean gestational age at birth was 36 (± 2) weeks. The mean of birth weight was 3.14 (± 0.85) kilograms. The average head circumference at birth was 33.82 cm (± 2.17). The mean diameter of the encephalocele/meningocele was 5.91 (± 1.02) cm. Other common central nervous system abnormalities included hydrocephalus, Dandy-Walker malformation, and agenesis of the corpus callosum. 40% required shunting for hydrocephalus. Surgery to remove the occipital sac occurred at a median age of 2.5 days (1.5-6.5). The most common post-surgical complication was the need for mechanical ventilation. The most common cause of death was pneumonia and the median age at death was 6.66 (0.03-18) months. CONCLUSION: Our findings suggest that neurosurgical intervention, especially for managing encephaloceles, may offer some improvement in survival, albeit within a context of generally poor prognosis. However, these results should be interpreted with caution.


Assuntos
Transtornos da Motilidade Ciliar , Encefalocele , Procedimentos Neurocirúrgicos , Doenças Renais Policísticas , Retinose Pigmentar , Humanos , Encefalocele/cirurgia , Encefalocele/diagnóstico por imagem , Retinose Pigmentar/cirurgia , Procedimentos Neurocirúrgicos/métodos , Transtornos da Motilidade Ciliar/cirurgia , Transtornos da Motilidade Ciliar/genética , Doenças Renais Policísticas/cirurgia , Doenças Renais Policísticas/genética , Anormalidades do Olho/cirurgia , Recém-Nascido
6.
Eur J Ophthalmol ; 34(3): NP87-NP91, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38377952

RESUMO

PURPOSE: To describe a case of acquired glaucomatous optic disc pit-related maculopathy successfully treated with glaucoma filtering surgery alone. CASE DESCRIPTION: A 67-year-old male was diagnosed with advanced primary open angle glaucoma in both eyes, with a cup: disc ratio of 0.85 in the right eye and 0.95 in the left eye. Visual acuity at presentation was 20/60, and intraocular pressure was 14 mm Hg in the left eye. The fundus of the left eye revealed a serous macular retinal detachment due to an acquired optic disc pit. RESULTS: The left eye of the patient underwent combined cataract and glaucoma filtering surgery. The serous macular detachment resolved completely 15 months after surgery, with a documented visual acuity of 20/40 and intraocular pressure of 10 mm Hg without the use of additional antiglaucoma medications. There was no recurrence of serous macular detachment even after the two-year follow-up visit. CONCLUSION: This case demonstrates that controlling intraocular pressure alone resulted in complete resolution of serous macular detachment in acquired optic disc pit maculopathy without the need for pars plana vitrectomy.


Assuntos
Glaucoma de Ângulo Aberto , Pressão Intraocular , Disco Óptico , Descolamento Retiniano , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Masculino , Disco Óptico/anormalidades , Idoso , Descolamento Retiniano/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Glaucoma de Ângulo Aberto/cirurgia , Glaucoma de Ângulo Aberto/fisiopatologia , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/complicações , Pressão Intraocular/fisiologia , Acuidade Visual/fisiologia , Angiofluoresceinografia , Cirurgia Filtrante/métodos , Anormalidades do Olho/complicações , Anormalidades do Olho/cirurgia
7.
J Cataract Refract Surg ; 50(5): 511-517, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38192060

RESUMO

PURPOSE: To characterize the morphology of persistent pupillary membranes (PPMs) in pediatric patients and explore the corresponding surgical approaches. SETTING: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN: Prospective observational study. METHODS: Consecutive pediatric patients with PPMs who underwent surgery from April 2020 to July 2022 were included. PPM morphology was assessed and categorized according to its anatomic relationship with crystalline lens and distribution of iris strands. The surgical approaches for different morphologies of PPMs were described in detail. The visual outcome and operation-related complications were recorded. RESULTS: 31 eyes from 19 patients were included with the mean age of 7.2 years. 3 morphological variants of PPMs were observed: type I (51.6%, 16/31), a spider-like appearance and no adhesion to the anterior lens capsule (ALC); type II (38.7%, 12/31), a loose central adherence to the ALC and partially thick iris strands attached to the iris collarette; type III (9.7%, 3/31), a tight central adherence to the ALC and only silk-like iris strands. Surgeries were performed with a natural pupil size in type I, while dilated pupil in the other types. The adhesions between PPM and the ALC were separated by viscoelastic injection in type II and by discission needles in type III. The corrected distance visual acuity was significantly improved from 0.34 ± 0.18 logMAR preoperatively to 0.17 ± 0.09 logMAR postoperatively ( P < .001). No operation-related complications were observed during 9.5-month follow-up. CONCLUSIONS: PPMs were categorized into 3 types according to their different morphologies, which helped to determine the best surgical strategy.


Assuntos
Acuidade Visual , Humanos , Estudos Prospectivos , Criança , Acuidade Visual/fisiologia , Feminino , Masculino , Pré-Escolar , Iris/cirurgia , Iris/anatomia & histologia , Anormalidades do Olho/cirurgia , Adolescente , Distúrbios Pupilares/cirurgia , Distúrbios Pupilares/fisiopatologia , Pupila/fisiologia
8.
Indian J Ophthalmol ; 72(2): 303, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38273697

RESUMO

BACKGROUND: Double optic disc pit maculopathy is a rare entity. It can be difficult to manage because of excessive leakage and chronic maculopathy. PURPOSE: To describe surgical management in a case of double optic disc pits with maculopathy. SYNOPSIS: A 42-year-old male presented with double optic disc pits with macular detachment in the left eye. The best-corrected visual acuity (BCVA) was 20/60, N12. Preoperative OCT showed the presence of two disc pits. The macular region had large retinoschisis and subretinal fluid (SRF) with a central foveal thickness of 879 microns and loss of the ellipsoid zone. A shallow communication from the temporal aspect of the disc to the submacular area was also noted. Among the options of observation, laser photocoagulation, and surgery, the patient opted for surgical management. SURGICAL TECHNIQUE: A standard-3 port 23-gauge pars plana vitrectomy was done. After staining the ILM with brilliant blue, ILM peeling was done with the help of forceps and Finesse loop. ILM flaps were inverted over to cover the optic disc pits and sealed with a drop of fibrin glue. Next, 20% SF6 gas was used for tamponade. Pre- and post-surgery parameters such as visual acuity and OCT were evaluated. POSTOPERATIVE EVALUATION: After 6 weeks, left eye BCVA was 20/40 with OCT showing reduced SRF and reduced intraretinal schisis with a foveal thickness of 546 microns. At 3 months of follow-up, the vision in the left eye had improved to 20/30 with further reduction in the retinoschisis and foveal thickness of 482 microns. HIGHLIGHTS: In this interesting case, we demonstrate a unique way of sealing the defect surgically by vitrectomy and inverted ILM flap with fibrin glue over the disc pits. Despite sealing the maculopathy is slow to resolve. VIDEO LINK: https://youtu.be/s9nY5UPe1s4.


Assuntos
Anormalidades do Olho , Degeneração Macular , Disco Óptico , Descolamento Retiniano , Doenças Retinianas , Retinosquise , Masculino , Humanos , Adulto , Retinosquise/diagnóstico , Retinosquise/cirurgia , Retinosquise/complicações , Descolamento Retiniano/cirurgia , Adesivo Tecidual de Fibrina , Tomografia de Coerência Óptica , Tamponamento Interno/efeitos adversos , Doenças Retinianas/cirurgia , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia , Anormalidades do Olho/complicações , Degeneração Macular/complicações , Vitrectomia/métodos , Fotocoagulação a Laser/efeitos adversos
9.
Eur J Ophthalmol ; 34(1): 11-17, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37073081

RESUMO

It concerns three siblings (two 28 year old twin boys and a 25 year old woman) who presented a previous history of rupture of eyeball in one eye and very poor vision in the other. At the first ophthalmoscopic and instrumental evaluation, three patients presented with bluish sclera and keratoglobus in the intact eye. A genetic analysis with whole exome sequencing was then performed on the three siblings, identifying a biallelic variant of the PRDM5 gene that led to the diagnosis of Brittle Cornea Syndrome (BCS), a rare autosomal recessive disorder characterized by corneal thinning and blue sclera. To preserve the only intact eye from possible breakage, the three siblings were trained in using protective measures (polycarbonate goggles etc.) to carry out close monitoring of symptoms and were asked to continue with follow-up visits for ocular and systemic diseases associated with BCS. Given the poor best corrected visual acuity achievable with glasses and contact lenses, penetrating keratoplasty was performed, achieving good visual acuity maintained in the 2-year follow-up in two of the three patients. Knowledge of this pathology and its clinical manifestations is essential for early diagnosis and correct management of this rare but very debilitating pathology. To our knowledge, this is the first case series of BCS reported in an Albanian population.


Assuntos
Anormalidades do Olho , Instabilidade Articular , Anormalidades da Pele , Masculino , Feminino , Humanos , Adulto , Ceratoplastia Penetrante , Anormalidades da Pele/diagnóstico , Anormalidades da Pele/genética , Anormalidades da Pele/cirurgia , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/genética , Anormalidades do Olho/cirurgia , Instabilidade Articular/diagnóstico , Instabilidade Articular/genética , Instabilidade Articular/cirurgia , Córnea/patologia
10.
Plast Reconstr Surg ; 153(2): 447-456, 2024 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-37053442

RESUMO

BACKGROUND: Unilateral coronal synostosis (UCS) results in a surgically demanding deformation, as the deformity is asymmetric in the calvaria but also presents with facial scoliosis and orbital dystopia. Traditional cranioplasties correct the forehead but have little effect on the face and orbits. In this article, the authors describe a consecutive series of patients operated on for UCS with osteotomy of the fused suture combined with distraction osteogenesis. METHODS: Fourteen patients (mean age, 8.0 months; range, 4.3 to 16.6 months) were included in this study. The authors measured and compared the orbital dystopia angle, anterior cranial fossa deviation, and anterior cranial fossa cant between preoperative computed tomography results and those at distractor removal. RESULTS: Blood loss was 6.1 mL/kg (range, 2.0 to 15.2 mL/kg), and length of stay was 4.4 days (range, 3.0 to 6.0 days). The authors observed significant improvements in the median orbital dystopia angle from 9.8 degrees (95% CI, 7.0 to 12.6 degrees) to 1.1 degrees (95% CI, -1.5 to 3.7 degrees) ( P < 0.001), anterior cranial fossa deviation from 12.9 degrees (95% CI, 9.2 to 16.6 degrees) to 4.7 degrees (95% CI, 1.5 to 7.9 degrees) ( P < 0.001), and anterior cranial fossa cant from 2.5 degrees (95% CI, 1.5 to 3.5 degrees) to 1.7 degrees (95% CI, 0.0 to 3.4 degrees) ( P = 0.003). CONCLUSIONS: Osteotomy combined with a distractor for UCS straightened the face and relieved orbital dystopia by affecting the nose angle relative to the orbits, correcting the deviation of the cranial base in the anterior fossa, and lowering the orbit on the affected side. Furthermore, this technique demonstrated a favorable morbidity profile with low perioperative bleeding and a short inpatient period, suggesting its potential to improve the surgical treatment of UCS. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Craniossinostoses , Anormalidades do Olho , Osteogênese por Distração , Humanos , Lactente , Craniossinostoses/diagnóstico por imagem , Craniossinostoses/cirurgia , Base do Crânio/cirurgia , Órbita/cirurgia , Osteotomia , Craniotomia/métodos , Anormalidades do Olho/cirurgia , Osteogênese por Distração/métodos , Suturas Cranianas/cirurgia
11.
Eur J Ophthalmol ; 34(1): NP127-NP132, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37264599

RESUMO

BACKGROUND: To describe OCT-angiography features in a case of an optic disk pit (ODP) which underwent a pars plana vitrectomy with inverted ILM flap for macular detachment. CASE PRESENTATION: A 12 years old child with an ODP responsible for a macular detachment underwent 23G vitrectomy in the subacute phase of the disease with an inverted ILM flap used as a plug over the lateral dehiscence of the pit. Among the various retinal imaging examinations performed in the post-operative period, the OCT-angiography showed very interesting features characterized by a capillary drop-out in correspondence of the superficial and deep capillary plexus, a fine texture of the choroid capillary layer and star-shaped folds in correspondence of both the outer retina and the choroid capillary layer. OCT-A performed 24 months after surgery showed a normalization of the macular perfusion which correlated with a full recovery of the visual acuity of the young child. CONCLUSIONS: OCT-A is an useful tool to monitor the subretinal fluid reabsorption after ILM inverted flap surgery for ODP-maculopathy and correlates with visual function. OCT-A may be useful in the follow-up of this rare condition as well as its response to therapeutic strategies.


Assuntos
Anormalidades do Olho , Disco Óptico , Descolamento Retiniano , Criança , Humanos , Angiografia , Anormalidades do Olho/diagnóstico por imagem , Anormalidades do Olho/cirurgia , Disco Óptico/diagnóstico por imagem , Retina , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos
12.
Cleft Palate Craniofac J ; 61(1): 155-158, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-36377243

RESUMO

Ankyloblepharon filiforme adnatum (AFA) is a rare, benign congenital anomaly. Notably, it is characterized by the adhesion of the ciliary edges of the upper and lower eyelids at the trabecular line. AFA is usually a solitary malformation of sporadic occurrence; however, it can occur in conjunction with other congenital diseases. Herein, we report a case of cleft lip with AFA. A patient was referred to the ophthalmology department of our hospital. The ophthalmic diagnosis was AFA in both the eyes. The left eye was observed to have a fibrous adhesion in the center, and she underwent surgery to excise the fibrous adhesion of tissue with scissors. The right eye was observed to have a fibrous adhesion in the external canthus and was excised during lip plasty. After surgery, her eyes were able to fully open, and no other apparent disease was diagnosed. AFA is thought to be caused by an ectodermal-derived developmental abnormality. Notably, cases of AFA with a cleft lip are rare. Diagnosis and surgery should be performed promptly to minimize any risk of amblyopia and for the early detection of congenital diseases, including glaucoma.


Assuntos
Fenda Labial , Fissura Palatina , Anormalidades do Olho , Anormalidades da Boca , Humanos , Feminino , Fenda Labial/cirurgia , Fenda Labial/diagnóstico , Fissura Palatina/cirurgia , Fissura Palatina/diagnóstico , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia , Aderências Teciduais
13.
Rev. bras. oftalmol ; 83: e0030, 2024. graf
Artigo em Português | LILACS | ID: biblio-1565364

RESUMO

RESUMO O anquiloblefáro filiforme congênito é uma rara anomalia congênita, caracterizada por uma fusão palpebral, parcial ou completa, cuja incidência é de 4,4 por 100 mil recém-nascidos. Normalmente, o anquiloblefáro filiforme congênito constitui uma malformação solitária, de ocorrência esporádica, no entanto, pode estar associado a outras malformações. O pediatra possui papel imprescindível para observar as alterações clínicas do recém-nascido e dar orientação para o tratamento adequado. O objetivo deste estudo foi relatar o caso de recém-nascido de termo que teve diagnóstico precoce de anquiloblefáro filiforme congênito associado a outras malformações congênitas, tendo desfeito as aderências em procedimento cirúrgico oportuno, evitando-se a evolução para futuras complicações visuais do paciente.


ABSTRACT Ankyloblepharon filiforme adnatum is a rare congenital anomaly, characterized by partial or complete palpebral fusion, with an incidence of 4.4 per 100,000 newborns. Normally, ankyloblepharon filiforme adnatum constitutes a solitary malformation, with sporadic occurrence, however, it can be associated with other malformations. Pediatricians play an essential role in observing clinical changes in newborns and providing guidance on appropriate treatment. The this study aims to report the case of a full-term newborn who had an early diagnosis of ankyloblepharon filiforme adnatum associated with other congenital malformations.


Assuntos
Humanos , Feminino , Recém-Nascido , Anormalidades do Olho/cirurgia , Anormalidades do Olho/diagnóstico , Pálpebras/anormalidades , Pálpebras/cirurgia , Anormalidades Congênitas/diagnóstico por imagem , Cesárea , Aderências Teciduais , Ultrassonografia Pré-Natal , Fenda Labial , Fissura Palatina , Sofrimento Fetal/diagnóstico por imagem
14.
Ophthalmologie ; 120(12): 1267-1272, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-37815542

RESUMO

PURPOSE: The aim of this case series was to investigate the clinical course of patients with optic pit maculopathy. METHODS: The medical records of all patients diagnosed with optic pit maculopathy in the past 10 years were reviewed. Optic pit maculopathy was diagnosed when localized intraretinal or/and subretinal fluid spread from the optic nerve to the macula. Outcome measures included changes in best corrected visual acuity (BCVA), central retinal thickness (RT) as well as nasal parafoveal and perifoveal RT. RESULTS: An optic disc pit was detected in 18 patients (9 female, 9 male, mean age: 33 ± 23 years). Retinal fluid accumulation was present in 6 (33.3%) of the patients (1 intraretinal, 1 subretinal, 4 intraretinal and subretinal). Pars plana vitrectomy with removal of peripapillary vitreous traction and peeling of the internal limiting membrane (ILM) was indicated in 5 patients and was performed in 4 patients. One patient underwent nanopulse laser treatment instead. The patients with optic pit maculopathy were 47 ± 16 years old. In this group of patients, mean BCVA (decimal) improved from 0.3 ± 0.2 before treatment to 0.5 ± 0.2 3 months after treatment (p = 0.03). Visual acuity improved in all patients with optic disc pit maculopathy after pars plana vitrectomy. The mean central RT decreased from 796 ± 214 before treatment to 324 ± 57 3 months after treatment (p = 0.005). The mean nasal parafoveal RT decreased from 683 ± 87 before treatment to 372 ± 41 (p = 0.0003) and the mean nasal perifoveal RT decreased from 547 ± 89 before treatment to 360 ± 48 (p = 0.007). A completely dry macula was achieved in 4 eyes after a mean follow-up of 3 months. At long-term follow-up (2.5 ± 1.2 years), no recurrence occurred in the vitrectomized eyes. CONCLUSION: This case series showed that more than one third of the patients had optic pit maculopathy presumably caused by disruption of the Kuhnt intermediate tissue. Interventional treatment was indicated in all cases, of which 4 were surgically treated and resulted in significant improvement of function and anatomical retinal structures.


Assuntos
Anormalidades do Olho , Degeneração Macular , Doenças Retinianas , Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Incidência , Tomografia de Coerência Óptica , Doenças Retinianas/diagnóstico , Anormalidades do Olho/cirurgia , Progressão da Doença
15.
J AAPOS ; 27(6): 354-357, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37741493

RESUMO

Aplasia of the inferior rectus and inferior oblique muscles is extremely rare. Failure of the normal embryologic development of the inferior mesodermal complex can lead to agenesis of inferior rectus, inferior oblique, and lower sections of the lateral rectus muscles. This rare condition is usually seen in association with craniofacial syndromes or in conjunction with microcornea, microphthalmos, Axenfeld-Rieger syndrome, and coloboma. The usual treatment for this condition is a reverse Knapp procedure to improve the vertical alignment; however, this procedure can lead to complications, such as anterior segment ischemia, undercorrection, and torsional problems. To our knowledge, unilateral inferior rectus and inferior oblique muscle aplasia has not been described previously in a patient with congenital facial nerve palsy and optic nerve hypoplasia. In the present case, the patient was successfully treated with a modified minimally invasive horizontal rectus muscle transposition procedure.


Assuntos
Anormalidades do Olho , Síndrome de Goldenhar , Estrabismo , Humanos , Músculos Oculomotores , Síndrome de Goldenhar/complicações , Síndrome de Goldenhar/cirurgia , Tenotomia/efeitos adversos , Estrabismo/cirurgia , Anormalidades do Olho/complicações , Anormalidades do Olho/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos
16.
J Cataract Refract Surg ; 49(6): 649-653, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37257174

RESUMO

A 51-year-old man was referred for refractive surgery evaluation. Spectacle dependence and poor visual quality in both eyes was his chief complaint. He cannot tolerate contact lenses. Corrected distance visual acuity (CDVA) was 20/40 in both eyes. Manifest refraction was +5.25 -2.25 @ 90 (20/40) in the right eye and +6.25 -2.25 @ 105 (20/40) in the left eye. The patient had a history of radial keratotomy (RK) almost 30 years ago in both eyes and at the slitlamp presented 8 RK incisions, proportionally spaced between one another. All incisions were closed, and there were no relevant signs of scarring. The patient denied any history of ocular trauma, systemic disease, or medications. Corneal topography with different technologies revealed an irregular pattern with marked central flattening in both eyes, with some points below 30 diopters (D) (Supplemental Figures 1 and 2, available at http://links.lww.com/JRS/A862 and http://links.lww.com/JRS/A863, respectively). There were no signs of cataract, and fundus examination was normal. Optical coherence tomography (OCT) of the right eye revealed a more homogeneous thickness pattern, little variation between the thinnest and thickest areas, and adequate transparency (Figure 1JOURNAL/jcrs/04.03/02158034-202306000-00018/figure1/v/2023-05-31T172126Z/r/image-tiff). In the left eye, there is wide variability between the thinnest and thickest stromal points, with annular thinning and central thickening (Figure 2JOURNAL/jcrs/04.03/02158034-202306000-00018/figure2/v/2023-05-31T172126Z/r/image-tiff). Both eyes show marked epithelial irregularity. Considering this patient's current ocular status, how would you reach visual rehabilitation? Because he is contact lens intolerant, would you consider surface ablation, for example, photorefractive keratectomy (PRK) with mitomycin-C (MMC)? If that were the case, would you think of an optimized or a topography-guided (TG) treatment? Would you immediately consider a corneal transplant option? Would you instead consider a more conservative approach? Which one and why?


Assuntos
Anormalidades do Olho , Hiperopia , Ceratotomia Radial , Ceratectomia Fotorrefrativa , Masculino , Humanos , Pessoa de Meia-Idade , Ceratotomia Radial/efeitos adversos , Hiperopia/cirurgia , Hiperopia/etiologia , Lasers de Excimer/uso terapêutico , Ceratectomia Fotorrefrativa/métodos , Anormalidades do Olho/cirurgia , Córnea/cirurgia , Refração Ocular
17.
Eur J Cardiothorac Surg ; 63(5)2023 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-37094228

RESUMO

Obstruction of a right cervical aortic arch in association with hypoplasia of the descending aorta is a rare congenital cardiac malformation. We report the case of a 6-month-old boy with posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies and eye anomalies (PHACE) syndrome and interruption of a right-sided cervical aortic arch. The descending thoracic aorta in the child had a long hypoplastic segment and the patient also had small ventricular septal defect and pulmonary valve stenosis. The surgical technique of reconstruction of the aortic arch and the descending thoracic aorta through a median sternotomy is described.


Assuntos
Coartação Aórtica , Anormalidades do Olho , Cardiopatias Congênitas , Síndromes Neurocutâneas , Masculino , Humanos , Criança , Lactente , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Aorta Torácica/anormalidades , Coartação Aórtica/complicações , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Anormalidades do Olho/complicações , Anormalidades do Olho/diagnóstico por imagem , Anormalidades do Olho/cirurgia , Síndromes Neurocutâneas/complicações , Cardiopatias Congênitas/cirurgia
18.
Zhonghua Yan Ke Za Zhi ; 59(3): 220-221, 2023 Mar 11.
Artigo em Chinês | MEDLINE | ID: mdl-36860111

RESUMO

A male neonate who was unable to open both eyes with the adhesion of upper and lower palpebral margins since birth was clinically diagnosed as bilateral ankyloblepharon filiforme adnatum. The fused eyelids were divided surgically under general anesthesia. The neonate can open and close eyes normally with right positions of eyelids and flexible movements of eyeballs to follow light after the surgery.


Assuntos
Anormalidades do Olho , Pálpebras , Humanos , Recém-Nascido , Masculino , Pálpebras/patologia , Pálpebras/cirurgia , Anormalidades do Olho/cirurgia
19.
Indian J Ophthalmol ; 71(2): 674, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36727392

RESUMO

Background: Optic disc pit-associated maculopathy (ODP-M) is a rare presentation in children. Therefore, only a few pediatric cases successfully managed have been reported in the literature. This video shows successful management of ODP-M with human amniotic membrane graft in a pediatric case presenting with recurrence with intraoperative optical coherence tomography (OCT). Purpose: To demonstrate a successful management of ODP-M with human amniotic membrane graft in a pediatric case presenting with recurrence. Synopsis: A 13-year-old patient who had been previously operated with 25-G pars plana vitrectomy with double internal limiting membrane peel and juxtapapillary endolaser with SF 6 gas tamponade for optic disc pit-associated maculopathy (ODP-M) presented with recurrence 9 months after primary surgery. Three 25-G sclerotomies were made and human amniotic membrane graft was tucked into the ODP; the position of the graft was confirmed with intraoperative ocular coherence tomography. Subretinal fluid rapidly resolved within 48 h and best-corrected visual acuity improved to 0.5 logMAR after one week. Later follow-ups showed no complications or recurrence. Highlights: This video shows successful management of ODP-M with human amniotic membrane graft in a pediatric case presenting with recurrence with intraoperative optical coherence tomography (OCT), without any additional tamponade. Video Link: https://youtu.be/rM79P7oU7GE.


Assuntos
Anormalidades do Olho , Degeneração Macular , Disco Óptico , Doenças Retinianas , Humanos , Criança , Adolescente , Âmnio , Acuidade Visual , Doenças Retinianas/etiologia , Anormalidades do Olho/complicações , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia , Degeneração Macular/complicações , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos
20.
Semin Ophthalmol ; 38(3): 275-282, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36788651

RESUMO

BACKGROUND: Peters' anomaly (PA) is the most commonly encountered congenital corneal opacity (CCO) and displays a wide phenotypical range. The relatively recent adoption of high-quality anterior segment imaging in the form of high-frequency ultrasound biomicroscopy and anterior segment optical coherence tomography has aided in the accurate diagnosis of CCOs, facilitated distinction of PA from "pseudo-Peters' anomaly," and aided in prognostication and surgical risk stratification in PA. While the definitive management of PA, especially the more severe forms, is penetrating keratoplasty (PK), long-term success rates have overall been disappointing. This spurred the development of more non-invasive procedures, such as optical iridectomy and the more recently described selective endothelial removal, which represent viable alternatives to PK, at least in the less severe phenotypes of PA. METHODS: Literature searches for the components of this review were performed using PubMed, in September 2021. The following keywords and their iterations were employed for the searches: "Peters' anomaly," "anterior segment dysgenesis," "kerato-irido-lenticular dysgenesis," "congenital corneal opacities." These were entered into the PubMed search engine, revealing 2852 related articles. The inclusion criteria included publications in the English language, specific to Peters' anomaly. Fifty-five studies that were published as systematic reviews or as nonrandomized comparative studies (cohort or case series) on the topic of Peters' anomaly were finally selected for this review. RESULTS: This review provides a summary of Peters' anomaly in the context of advances in diagnosis, classification, and genotype-phenotype correlation of congenital corneal opacities, with a focus on penetrating keratoplasty, its outcomes, and non-invasive surgical options. While conservative therapies such as spontaneous clearing, mydriatic eye drops, and optical iridectomy may have variable success in milder variants of PA, penetrating keratoplasty in these eyes is fraught with several challenges and typically results in poor long-term functional outcomes. The management strategy depends on several variables such as phenotypical severity of PA, laterality, age at presentation, and capacity to adhere to the follow-up schedule. Notwithstanding the choice of treatment, it is essential that early and aggressive amblyopia therapy, a thorough systemic examination, and appropriate referral are undertaken for all patients of PA. CONCLUSION: Peters' anomaly has seen recent advances in diagnosis, but treatment options remain limited. Focus directed towards less-invasive alternatives to keratoplasty may yield better functional outcomes.


Assuntos
Opacidade da Córnea , Anormalidades do Olho , Humanos , Ceratoplastia Penetrante , Opacidade da Córnea/diagnóstico , Opacidade da Córnea/cirurgia , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/anormalidades , Estudos Retrospectivos
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