RESUMO
ABSTRACT We describe a case of keratomycosis caused by Arthographis kalrae after excimer laser keratomileusis. A 38-year-old female developed stromal keratitis eight weeks after refractive surgery. She developed severe corneal stromal infiltration and mild anterior segment inflammation, which could not be treated with topical voriconazole 1%, but topical natamycin 5% ameliorated her condition. A reactivation of keratomycosis symptoms was observed; therefore, longer treatment was administered to the patient. It has been reported that A. kalrae keratomycosis is associated with exposure to soil and contact lens usage. However, the patient, who lived in a rural location, was neither involved in gardening activities nor had a history of wearing contact lenses. This is the first case of post-refractive A. kalrae keratomycosis.
RESUMO Descrevemos um caso de ceratomicose por Arthographis kalrae após ceratomileusis por excimer laser. Uma mulher de 38 anos desenvolveu ceratite estromal oito semanas após a cirurgia refrativa. Ela desenvolveu infiltração estromal grave da córnea e uma leve inflamação do segmento anterior, que não pode ser tratada com voriconazol tópico a 1%, mas a natamicina tópica a 5% melhorou sua condição. Uma reativação dos síntomas de ceratomicose foi observada; portanto, tratamento mais prolongado foi administrado a paciente. Tem sido relatado que a ceratomicose por A. kalrae está associada à exposição ao solo e ao uso de lentes de contato. No entanto, a paciente, que vivía em um local rural, não estava envolvida em atividades de jardinagem e nem tinha histórico de uso de lentes de contato. Este é o primeiro caso de ceratomicose pós-refrativa por A. kalrae.
Assuntos
Humanos , Feminino , Adulto , Infecções Oculares Fúngicas/microbiologia , Ceratite/microbiologia , Ascomicetos/isolamento & purificação , Infecções Oculares Fúngicas/tratamento farmacológico , Natamicina/uso terapêutico , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Voriconazol/uso terapêutico , Ceratite/tratamento farmacológicoRESUMO
We describe a case of keratomycosis caused by Arthographis kalrae after excimer laser keratomileusis. A 38-year-old female developed stromal keratitis eight weeks after refractive surgery. She developed severe corneal stromal infiltration and mild anterior segment inflammation, which could not be treated with topical voriconazole 1%, but topical natamycin 5% ameliorated her condition. A reactivation of keratomycosis symptoms was observed; therefore, longer treatment was administered to the patient. It has been reported that A. kalrae keratomycosis is associated with exposure to soil and contact lens usage. However, the patient, who lived in a rural location, was neither involved in gardening activities nor had a history of wearing contact lenses. This is the first case of post-refractive A. kalrae keratomycosis.
Assuntos
Infecções Oculares Fúngicas/microbiologia , Ceratite/microbiologia , Adulto , Ascomicetos/isolamento & purificação , Infecções Oculares Fúngicas/tratamento farmacológico , Feminino , Humanos , Ceratite/tratamento farmacológico , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Natamicina/uso terapêutico , Voriconazol/uso terapêuticoAssuntos
Endocardite/complicações , Febre Q/complicações , Hemorragia Retiniana/diagnóstico por imagem , Insuficiência da Valva Aórtica , Calcinose/diagnóstico , Calcinose/microbiologia , Coxiella burnetii/isolamento & purificação , Endocardite/cirurgia , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Febre Q/cirurgia , Hemorragia Retiniana/etiologiaRESUMO
AIM: To compare the efficacy, tolerability and safety of bromfenac 0.09%, nepafenac 0.1% or diclofenac 0.1% for the prophylaxis of the cystoid macular edema (CME) after phacoemulsification. METHODS: Group sequential observational comparative study. After phacoemulsification, patients received two months for topical treatment of either diclofenac sodium, bromfenac or nepafenac. All patients received concomitant topical tobramycin 0.3% and topical prednisolone 1%. We measured CME using optical coherence tomography (OCT) central foveal thickness, macular thickness and total macular volume. RESULTS: We enrolled 243 patients from January to June 2015, and 35% received diclofenac, 32.9% bromfenac and 32.1% nepafenac. When we compared pre-operative to three weeks to two months, bromfenac was more effective in reducing foveal volume (21.3 and 35.4 mm3, respectively), compared with the diclofenac (1.3 and 11.5 mm3, respectively), and the nepafenac group, became more edematous 6.4 and 5.3, respectively. Totally 133 patients completed the post-surgical satisfaction questionnaire. Patients complained of eye stickiness in 13.8% whom we gave nepafenac, versus 10.3% whom we gave diclofenac sodium, and in 0 whom we gave bromfenac. CONCLUSION: Bromfenac is the best tolerated and is more effective than diclofenac and nepafenac in reducing CME after phacoemulsification.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Oculares/secundário , Iris/patologia , Neoplasias Pulmonares/patologia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/patologia , Evolução Fatal , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
El desprendimiento de retina exudativo es una causa poco común de pérdida visual en la preeclampsia. Su patogenia no es del todo conocida, aunque la isquemia coroidea pudiera jugar un papel fundamental. Existen pocos casos reportados en la literatura y la mayoría hace referencia a casos aislados o series cortas de casos. Presentamos el caso de una primigesta de 34 años en el tercer trimestre de embarazo con un desprendimiento de retina exudativo bilateral. La sintomatología visual fue la primera manifestación de una preeclampsia que terminó en cesárea de urgencia. La clínica oftalmológica se resolvió de forma espontánea a las dos semanas de la cesárea(AU)
Exudative retinal detachment is an uncommon cause of loss of visual acuity in preeclampsia. Its pathogenesis is not fully understood, but choroidal ischaemia is known to play a key role. Few cases have been reported, and most of these refer to isolated cases or short series of cases. We describe the case of a primigravida aged 34 years, in the third trimester of pregnancy, with bilateral exudative retinal detachment. The visual symptoms were the first manifestation of preeclampsia, which finally required an emergency caesarean section. The retinal detachment resolved spontaneously within two weeks of the caesarean section(AU)