Calcium oxalate crystals retinopathy following domino liver transplant: A case report.

INTRODUCTION: Hyperoxaluria is a rare cause of hereditary crystalline retinopathy. We report the first case of acquired calcium oxalate crystalsretinopathy following domino liver transplantation (DLT). CLINICAL CASE: A 72-year-old patient was referred for bilateral visual impairment 9 months after DLT. Slit lamp examination was unremarkable. Fundus examination revealed calcium oxalate crystals accumulation within both retina. Owing to multi-organ failure, the patient underwent combined liver-kidney retransplantation. During the following two years, calcium oxalate crystals accumulation within the retina gradually decreased and visual acuity improved. Nevertheless, OCT-angiography revealed abnormalities in the inner and outer retinal vascular plexus (i.e. retinal vessels occlusion and dilatation). Visual field examination revealed bilateral constriction associated with decreased optic nerve fibre layer thickness suggesting optic nerve atrophy. CONCLUSION: This case highlights the need for ophthalmologists to consider the diagnosis of acquired hyperoxaluria in patients with progressive bilateral visual impairment following DLT, especially if the postoperative course is marked by renal failure. Moreover, even after liver-kidney transplantation with a conventional graft, visual function can remain impaired owing to maculopathy and optic atrophy.

A comparison of the ASD experience of low-SES hispanic and non-hispanic white parents.

This study compared the experiences of Hispanic families, who were primarily of Mexican heritage, and non-Hispanic White families from the United States both from low socioeconomic status (SES) backgrounds having a child with a diagnosis of Autism Spectrum Disorder (ASD). The Centers for Disease Control and Prevention (CDC) reports that Hispanic children are diagnosed with ASD 2 years later than non-Hispanic White children [Baio et al., MMWR Surveillance Summaries 2018:67(SS-6): 1-23]. However, there has been limited investigation in exploring how SES might impact both diagnosis and experience. A survey of basic demographic information and a qualitative survey were used for this study. Basic demographic information obtained included SES, parent educational level, age of diagnosis of the children, religious affiliation, and marital status. Hour-long interviews were conducted to gather information about the personal experiences of these families relating to diagnoses and treatment. Comparative results of basic demographic information showed no difference in age of diagnosis between the two groups when SES was controlled. Although SES was controlled, the non-Hispanic White families had a higher education level and were slightly wealthier. Qualitatively, similarities included family support, doctor response to parent concerns, and acceptance of diagnosis by family members and friends. Differences included religious views, acceptance of diagnosis, knowledge of developmental milestones, and finding resources. Most significantly, the findings indicate no difference in the age of diagnosis of ASD between the Hispanic and non-Hispanic White children, which could be attributed to increased awareness and having access to a proactive parent organization. Autism Res 2019, 12: 1880-1890. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study showed that Hispanic and Non-Hispanic White children from poor backgrounds got a diagnosis of Autism Spectrum Disorder (ASD) at the same age. Results show differences in religious views, acceptance of diagnosis, knowledge of milestones, and finding resources. This might be because people are more aware of ASD today and Hispanic families were involved with an active parent organization.