RESUMO
CLINICAL CASE: A 38-year-old man with fungal Alternaria keratitis was referred from another hospital 25 days after post-traumatic penetrating keratoplastia surgery on his right eye. We commenced treatment with topical voriconazole and the condition resolved. DISCUSSION: Fungal Alternaria keratitis is rare, and treatment is difficult because the clinical response does not correlate well with the antibiotic in vitro sensitivity of the fungus. Clinical cases need to be diagnosed and treated quickly if visual loss is to be avoided. The combination of topical and systemic voriconazole has been shown to be an effective treatment for this condition
Assuntos
Alternaria , Antifúngicos/administração & dosagem , Infecções Oculares Fúngicas/tratamento farmacológico , Ceratite/tratamento farmacológico , Micoses , Pirimidinas/administração & dosagem , Triazóis/administração & dosagem , Administração Oral , Adulto , Infecções Oculares Fúngicas/microbiologia , Traumatismos Oculares/cirurgia , Humanos , Ceratite/microbiologia , Ceratoplastia Penetrante , Masculino , Micoses/tratamento farmacológico , Soluções Oftálmicas , Fatores de Tempo , Resultado do Tratamento , VoriconazolRESUMO
PURPOSE: To evaluate the anterior chamber configuration by means of ultrasound biomicroscopy in patients with glaucoma and control subjects, and to determine quantitative changes in this configuration after glaucoma filtration surgery (trabeculectomy) and combined cataract and filtration surgery. METHODS: The study included 33 eyes of 33 patients with glaucoma (diagnosed with primary open-angle or exfoliative glaucoma) in which filtration surgery (n = 17) or combined cataract and filtration surgery (n = 16) was performed, and 25 eyes of 25 age-matched control subjects. Ultrasound biomicroscopy was used to measure anterior chamber depth and the angle width at 500 microm from the scleral spur in all eyes. The patients with glaucoma were examined 2 days before surgery and 3 and 6 months after surgery. RESULTS: There were no significant differences in anterior chamber depth and angle width between patients with glaucoma before surgery and control subjects. Postoperative values for anterior chamber depth were significantly greater in patients with glaucoma who underwent combined surgery, but no significant changes were observed in those who underwent filtration surgery alone. In contrast, angle width was significantly greater after surgery both in patients who underwent combined surgery and in those who underwent filtration surgery alone. CONCLUSION: On ultrasound biomicroscopic evaluation, there were no differences in anterior chamber depth and angle width between patients with glaucoma and control subjects. Trabeculectomy alone widens the angle but does not affect the anterior chamber depth; however, combined surgery both deepens the anterior chamber depth and widens the angle.
Assuntos
Câmara Anterior/diagnóstico por imagem , Glaucoma de Ângulo Aberto/cirurgia , Trabeculectomia , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/cirurgia , Extração de Catarata , Síndrome de Exfoliação/complicações , Feminino , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Glaucoma de Ângulo Aberto/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Prognóstico , Estudos Prospectivos , UltrassonografiaRESUMO
The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.
Assuntos
Neoplasias de Tecido Muscular/ultraestrutura , Neoplasias Orbitárias/ultraestrutura , Desmina/metabolismo , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecido Muscular/metabolismo , Neoplasias Orbitárias/metabolismo , Proteínas S100/metabolismoAssuntos
Âmnio/fisiologia , Curativos Biológicos , Procedimentos Cirúrgicos Oftalmológicos , Animais , Movimento Celular , Túnica Conjuntiva/cirurgia , Córnea/cirurgia , Criopreservação , Citocinas/biossíntese , Células Epiteliais/citologia , Substâncias de Crescimento/biossíntese , Humanos , Inflamação , CoelhosRESUMO
Fungi belonging to the genus Acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin B was unsuccessful and the infection eventually resolved with penetrating keratoplasty.