Bilateral congenital dacryocystocoeles with concurrent intranasal mucocoeles causing respiratory distress in a neonate.

Congenital dacryocystocoeles are uncommon, presenting as a fluctuant bluish mass inferior to the medial canthus. Even more rarely, these dacryocystocoeles are complicated by intranasal extension. We present a case of a newborn infant with bilateral dacryocystocoeles with intranasal extension (intranasal mucocoeles) causing respiratory distress and feeding difficulties. Prompt surgical correction was performed, with the mucocoeles being de-roofed, leading to the resolution of the dacryocystocoeles. The aetiology, clinical features, and therapeutic options are discussed.

Uveal Effusion: Clinical Features, Management, and Visual Outcomes in a Retrospective Case Series.

PURPOSE: To present the experience of a tertiary care ophthalmic institution in the assessment and management of uncommon causes of uveal effusion and related complications. MATERIALS AND METHODS: A retrospective chart review was conducted of 12 patients diagnosed with uveal effusion and managed at our institution between 1996 and 2012. The presenting features, investigations, management, and outcomes were analyzed for each case. RESULTS: The case series encompasses a variety of clinical conditions that cause uveal effusion including inflammatory, hydrostatic, and idiopathic mechanisms. Two thirds of the patients presented with secondary angle closure. Half of the patients had serous retinal detachment. Modern imaging techniques including ultrasound biomicroscopy and high-resolution magnetic resonance imaging were critical in making the diagnosis. Seven of the 12 patients responded to medical treatment and 4 required scleral surgery. Uveal effusions resolved in all patients after treatment. CONCLUSIONS: Uveal effusion is a complex and poorly understood clinical entity with significant visual morbidity and is caused by a range of ocular and systemic diseases. Effective management is critically dependent on the underlying cause.

Contrast-induced transient cortical blindness.

We present a case of transient cortical blindness secondary to contrast medium toxicity. A 58-year-old man had successful endovascular coiling of a right posterior inferior cerebellar artery aneurysm but became confused and unable to see after the procedure. His visual acuity was no light perception bilaterally. Clinically, there was no new intra-ocular pathology. An urgent non-contrast computed tomography scan of the brain showed cortical hyperdensity in both parieto-occipital cortices, consistent with contrast medium leakage through the blood-brain barrier from the coiling procedure. The man remained completely blind for 72 hours, after which his visual acuity improved gradually back to his baseline level.

Erectile dysfunction following intravitreal bevacizumab.

Despite initial concerns regarding systemic complications, the use of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for ocular disease is rapidly expanding worldwide, in terms of both the number of patients injected and its indications. To our knowledge, there are no cases in the literature reporting erectile dysfunction following the use of intravitreal bevacizumab. We postulate an organic mechanism for impaired erectile function due to systemically absorbed intravitreal bevacizumab. We describe a case of erectile dysfunction following intravitreal bevacizumab administration. Color fundus photos, fluorescein angiogram and optical coherence tomography images are presented. A 40-year-old male underwent intravitreal bevacizumab therapy for macular edema secondary to a branch retinal vein occlusion. He subsequently developed transient erectile dysfunction after each of his two bevacizumab injections. His only comorbidity was mild hypertension. Erectile dysfunction may be a side effect of intravitreal bevacizumab. The erectile dysfunction could be organic and/or psychogenic in etiology.