RESUMEN
Orbital mass is an exceedingly rare presentation of acute lymphoblastic leukemia. This report describes a 12-year-old boy with recurrent orbital pre-B-cell acute lymphoblastic leukemia and reviews the literature on the incidence, presentation, prognosis, and management of orbital tumors in acute lymphoblastic leukemia. Early diagnosis and treatment of orbital acute lymphoblastic leukemia with a multidisciplinary approach is essential to minimize or prevent deterioration of vision and optimize clinical outcomes.
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Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Orbitales/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Enfermedad Aguda , Biopsia , Médula Ósea/patología , Niño , Terapia Combinada , Diagnóstico Diferencial , Progresión de la Enfermedad , Resultado Fatal , Humanos , Imagen por Resonancia Magnética , Masculino , Recurrencia Local de Neoplasia/terapia , Neoplasias Orbitales/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/terapiaAsunto(s)
Traumatismos por Explosión/diagnóstico , Lesiones Oculares/diagnóstico , Personal Militar , Adulto , Campaña Afgana 2001- , Lesiones Oculares/clasificación , Lesiones Oculares/prevención & control , Dispositivos de Protección de los Ojos , Femenino , Humanos , Guerra de Irak 2003-2011 , Masculino , Persona de Mediana Edad , Índices de Gravedad del Trauma , Adulto JovenRESUMEN
AIM: The aim of this study was to describe 3 cases of postoperative fungal endophthalmitis successfully treated with anterior chamber washout, pars plana vitrectomy, and intracameral and intravitreal voriconazole injection. RESULTS: Three (3) patients from a single retina center in India developed culture-proven fungal endophthalmitis after cataract surgery in 1 eye. All patients underwent anterior chamber washout, pars plana vitrectomy, and intracameral and intravitreal voriconazole injections intraoperatively. All cases demonstrated substantial improvement in vision and intraocular inflammation after surgery. CONCLUSIONS: The combination of anterior chamber washout, pars plana vitrectomy, and intracameral and intravitreal voriconazole injection is a viable therapeutic option in cases of fungal endophthalmitis.
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Antifúngicos/uso terapéutico , Extracción de Catarata/efectos adversos , Endoftalmitis/tratamiento farmacológico , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , Anciano , Cámara Anterior/metabolismo , Antifúngicos/administración & dosificación , Endoftalmitis/etiología , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Pirimidinas/administración & dosificación , Estudios Retrospectivos , Triazoles/administración & dosificación , Vitrectomía , Cuerpo Vítreo/metabolismo , VoriconazolRESUMEN
PURPOSE: To understand factors associated with poor attendance of follow-up appointments for care of glaucoma (GL), AMD, and diabetic retinopathy (DR) in a tertiary referral center, and to identify strategies to improve adherence. METHODS: Cross-sectional study of 240 adults attending follow-up appointments for GL, AMD, or DR. Cases (N = 102) were patients with poor follow-up who missed and failed to reschedule an appointment within 1 month of the recommended follow-up date during the preceding year. Controls (N = 138) were patients who completed the assigned follow-up. Data regarding the factors impacting adherence to appointments were collected via an orally administered questionnaire. Multivariate logistic regression was performed to determine factors associated with poor follow-up. RESULTS: In a multivariate logistic regression model, independent factors significantly associated with poor follow-up included incorrectly answering more than 50% of questions about eye disease (adjusted odds ratio [OR] = 3.24, P = 0.001), legal blindness (adjusted OR 2.64, P = 0.013), the presence of glaucomatous versus retinal disease (adjusted OR 2.06, P = 0.013), and difficulty for the study subject and/or escort taking time away from work for the appointments (adjusted OR 1.80, P = 0.049). Subjects identified the following strategies to improve follow-up: contact with others having the same eye condition (41.3%), greater education regarding eye disease (40.8%), and improved transportation services to the clinic (44.6%). CONCLUSIONS: Low disease knowledge scores, legal blindness, and difficulty getting time away from work for appointments adversely impacted follow-up independent of eye disease diagnosis. Improvements in patient education, transportation services, and clinic efficiency may increase adherence to recommended appointment intervals.
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Citas y Horarios , Atención a la Salud/normas , Oftalmopatías/terapia , Cooperación del Paciente/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Adulto , Enfermedad Crónica , Estudios Transversales , Atención a la Salud/tendencias , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Encuestas y Cuestionarios , Estados UnidosAsunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Aptámeros de Nucleótidos/uso terapéutico , Neovascularización Coroidal/tratamiento farmacológico , Degeneración Macular/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Animales , Anticuerpos Monoclonales Humanizados , Neovascularización Coroidal/etiología , Neovascularización Coroidal/metabolismo , Humanos , Degeneración Macular/complicaciones , Degeneración Macular/metabolismo , Ranibizumab , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/efectos de los fármacos , Factor A de Crecimiento Endotelial Vascular/metabolismoRESUMEN
PURPOSE: To describe a case of sarcoidosis manifesting as a unilateral posterior uveitis and retinal arteritis. DESIGN: Interventional case report. METHODS: Clinical examination, fluorescein angiography, radiological imaging, and laboratory testing revealed evidence of a primary arteritis associated with sarcoidosis. RESULTS: A 39-year-old white male presented with unilateral decreased vision, disc edema, exudative maculopathy, and retinal arteritis. Lab work and imaging were consistent with sarcoidosis. The patient responded to a 2-month course of oral prednisone and a sub-Tenon's triamcinolone injection. CONCLUSIONS: Sarcoidosis should be considered in the differential diagnosis of uveitis associated with a primary retinal arteritis.
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Arteritis/diagnóstico , Vasculitis Retiniana/diagnóstico , Sarcoidosis/diagnóstico , Adulto , Arteritis/tratamiento farmacológico , Arteritis/patología , Diagnóstico Diferencial , Humanos , Inmunosupresores/uso terapéutico , Masculino , Peptidil-Dipeptidasa A/sangre , Prednisona/uso terapéutico , Vasculitis Retiniana/tratamiento farmacológico , Vasculitis Retiniana/patología , Sarcoidosis/tratamiento farmacológico , Sarcoidosis/patología , Resultado del Tratamiento , Triamcinolona/uso terapéutico , Uveítis/tratamiento farmacológico , Uveítis/patología , Agudeza VisualRESUMEN
In 50 patients undergoing anterior segment intraocular surgery we determined that a three-day course of topical ofloxacin followed by preoperative povidone-iodine irrigation caused a marked decrease in the number of conjunctival bacterial flora and resulted in no contamination of the anterior chamber aqueous fluid at the beginning and conclusion of surgery.
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Segmento Anterior del Ojo/cirugía , Antibacterianos/administración & dosificación , Antiinfecciosos Locales/administración & dosificación , Ofloxacino/administración & dosificación , Procedimientos Quirúrgicos Oftalmológicos , Povidona Yodada/administración & dosificación , Cuidados Preoperatorios , Administración Tópica , Antibacterianos/uso terapéutico , Antiinfecciosos Locales/uso terapéutico , Humor Acuoso/microbiología , Bacterias/aislamiento & purificación , Conjuntiva/microbiología , Esquema de Medicación , Humanos , Ofloxacino/uso terapéutico , Periodo Posoperatorio , Povidona Yodada/uso terapéutico , Estudios Prospectivos , Irrigación Terapéutica , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To evaluate the safety and efficacy of intravitreal bevacizumab (Avastin, Genentech Inc.) for the treatment of neovascular age-related macular degeneration (ARMD). METHODS: A retrospective review was performed on consented patients with neovascular ARMD receiving intravitreal bevacizumab therapy. All patients received intravitreal bevacizumab at baseline with additional monthly injections given at the discretion of the treating physician. At each visit, a routine Snellen visual acuity assessment was performed followed by an ophthalmic examination and optical coherence tomography (OCT) imaging. RESULTS: Fifty-three eyes of 50 patients received an intravitreal bevacizumab injection between May and August 2005. Including the month 3 visit, the average number of injections was 2.3 out of a maximum of 4 injections. No serious drug-related ocular or systemic adverse events were identified. Improvements in visual acuity and central retinal thickness measurements were evident by week 1 and continued through month 3. At month 3, the mean visual acuity improved from 20/160 to 20/125 (P < 0.001) and the mean central retinal thickness decreased by 99.6 microm (P < 0.001). CONCLUSION: Off-label intravitreal bevacizumab therapy for neovascular ARMD was well tolerated over 3 months with improvements in visual acuity and OCT central retinal thickness measurements. While the long-term safety and efficacy of intravitreal bevacizumab remain unknown, these short-term results suggest that intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD.