RESUMO
We present a case of Purtscher-like retinopathy (PLR) following carotid angioplasty and stenting (CAS). A 56-year-old man with a history of severe stenosis of the left carotid artery and treated by CAS refers acute and painless visual loss on the left eye (OS) 48â h after the procedure. Funduscopic examination showed cotton wool spots and intraretinal hemorrhages confined to the peripapillary and posterior pole of the OS. The optical coherence tomography (OCT) showed retinal thickening and hyperintense lesions in the inner nuclear layer retina.
Assuntos
Estenose das Carótidas , Traumatismos Oculares , Doenças Retinianas , Masculino , Humanos , Pessoa de Meia-Idade , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/cirurgia , Estenose das Carótidas/patologia , Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Doenças Retinianas/patologia , Retina/patologia , AngioplastiaRESUMO
Small-cell lung cancer may directly affect the eye by metastatic proliferation or indirectly by paraneoplastic syndromes. The choroid is the most common site for uveal metastasis (90%); however, the iris can be involved in a smaller proportion of cases (incidence <10%). Blurred vision, pain, redness, photophobia, glaucoma, hyphema and visual field defects can arise from this metastatic involvement. The median survival time for patients with iris metastasis is reported to be 4 months. Secondary glaucoma can be managed with topical and oral treatment, transscleral cyclophotocoagulation, laser trabeculoplasty, anti-VEGF, Minimally Invasive Glaucoma Surgery (MIGS), filtering surgery, shunting surgery or enucleation. A case of primary small-cell lung cancer with iris metastasis is presented. The metastases produced an angle-closure glaucoma, which was refractory to topical treatment. Local radiotherapy was administered, obtaining a good local response.