RESUMO
A 43-year-old male presented with sudden onset of painless, blurred vision in his left eye. Dilated fundoscopic examination showed signs consistent with the diagnosis of a combination of central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO). He received daily 2-h sessions of hyperbaric oxygen treatment (HBOT), 253 kPa for 14 days. At the end of the HBOT course, the patient's left visual acuity had improved from 20/200 to 20/20. Dilated fundoscopic examination showed that the intra-retinal haemorrhages in the entire retina and the retinal whitening along the course of the CLRA seen at presentation had completely resolved. The combination of CLRAO and CRVO comprises a discrete clinical entity. Even though there are many hypotheses concerning this condition, it is most likely the result of elevated intraluminal pressure in the retinal capillaries due to CRVO that exceeds the pressure in the CLRA. HBOT may be an effective treatment for CRVO-associated CLRAO.
Assuntos
Oxigenoterapia Hiperbárica/métodos , Oclusão da Artéria Retiniana/terapia , Oclusão da Veia Retiniana/terapia , Transtornos da Visão/terapia , Adulto , Artérias Ciliares , Angiofluoresceinografia , Humanos , Masculino , Doenças Raras/terapia , Oclusão da Artéria Retiniana/complicações , Hemorragia Retiniana/terapia , Oclusão da Veia Retiniana/complicações , Acuidade VisualRESUMO
Ocular signs and symptoms of Ebola infection initially suggest banal conjunctivitis, but in advanced cases severe haemorrhagic conjunctivitis appears and, in the final stage of the disease, retinal and chorioidal haemorrhages may occur which can cause even blindness. Although the viral infection accompanied by ocular symptoms of a non-specific conjunctivitis, the high fever present from the onset of the disease should raise the suspicion of Ebola infection. There is no causal therapy know so far, and the only adjunctive treatment may be delivered by an ophthalmologist. Because the virus can be detected in the tear, it can theoretically be the mediator of the infection and, therefore, ophthalmological examinations should be carried out with the highest caution. In case of suspected Ebola infection the nearest competent healthcare authority should be immediately alerted in order to take further actions.
Assuntos
Oftalmopatias/terapia , Oftalmopatias/virologia , Febre/virologia , Doença pelo Vírus Ebola/complicações , Doença pelo Vírus Ebola/diagnóstico , Conjuntivite/terapia , Conjuntivite/virologia , Oftalmopatias/diagnóstico , Humanos , Hemorragia Retiniana/terapia , Hemorragia Retiniana/virologiaAssuntos
Neoplasias das Glândulas Suprarrenais/complicações , Feocromocitoma/complicações , Hemorragia Retiniana/etiologia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/métodos , Pré-Escolar , Diagnóstico Diferencial , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Hipertermia Induzida/métodos , Laparoscopia , Imageamento por Ressonância Magnética , Feocromocitoma/diagnóstico , Feocromocitoma/cirurgia , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/terapiaRESUMO
A 70-year-old woman with long-term poor vision was found to have unilateral massive premacular hemorrhage and asteroid hyalosis. Transpupillary thermotherapy (TTT) was applied sequentially to the vitreous in four separate spots, covering the area of the asteroid hyalosis and hemorrhage. Outcome measures included visual acuity, biomicroscopic appearance, ultrasonography, and fluorescein angiography. Significant resolution of the hemorrhage was observed 3 months after TTT, with visual acuity improvement from counting fingers at 25 cm to 20/60. There were no complications noted during the procedure or during follow-up. The long-term safety measures and visual prognosis following TTT for resolution of the vitreous impurities remain to be evaluated, but the procedure may be effective for treating premacular hemorrhage and asteroid hyalosis.