RESUMEN
Two cases of multifocal unilateral acute idiopathic maculopathy are presented, one in a 24 year-old man, and another in a 37 year-old woman. Both of them presented with acute vision loss and clinical findings compatible with unilateral acute idiopathic maculopathy. As a relatively uncommon finding, they had multifocal lesions around a larger central lesion. They experienced a spontaneous improvement of their vision. Atypical presentations of unilateral acute idiopathic maculopathy like multifocal lesions are possible. Ophthalmologists should be aware of this rare form of presentation.
RESUMEN
A 51 year-old man with hairy cell leukaemia was treated with pentostatin. While receiving the treatment, he was diagnosed with herpes retinitis in his right eye. After the last cycle of pentostatin the patient developed a mild vitritis and cystoid macular oedema. There were no signs of herpes retinitis reactivation. After excluding other possible causes of intraocular inflammation, a diagnosis of immune recovery uveitis was made. The patient was treated with 2-monthly retro-septal injections of triamcinolone, oral corticosteroids, intravitreal dexamethasone implants and, finally, pars plana vitrectomy. An immune recovery uveitis-like response is possible in HIV negative individuals. The immune reconstitution after the treatment of hairy cell leukaemia may have led to intraocular inflammation. Management of immune recovery uveitis is challenging and difficult. Pars plana vitrectomy may be necessary. Ophthalmologists should be alert to the possibility of immune recovery uveitis in HIV negative patients.
Asunto(s)
Infecciones por Herpesviridae , Síndrome Inflamatorio de Reconstitución Inmune/inmunología , Leucemia de Células Pilosas/complicaciones , Retinitis/virología , Uveítis/inmunología , Antineoplásicos/uso terapéutico , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/diagnóstico , Leucemia de Células Pilosas/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Pentostatina/uso terapéutico , Uveítis/diagnóstico , Agudeza VisualRESUMEN
A 32 year-old man who presented with severe elevation of blood pressure after failure of kidney transplant. The patient had multiple serous retinal detachments, venous dilation, arteriolar narrowing, retinal haemorrhages, as well as optic disc oedema. Due to the impossibility of performing a fluorescein angiography, an angiotomography and en-face optical coherence tomography images were used to identify the vascular alterations in the retina, choroid, and choriocapillaris. Angiotomography and en face-optical coherence tomography mode images are very useful in cases where it is not possible to perform fluorescein angiography.
Asunto(s)
Hipertensión Maligna/complicaciones , Trasplante de Riñón/efectos adversos , Adulto , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Humanos , Riñón/lesiones , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Masculino , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Insuficiencia Renal/cirugía , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/etiología , Hemorragia Retiniana/diagnóstico por imagen , Hemorragia Retiniana/etiología , Oclusión de la Vena Retiniana/diagnóstico por imagen , Oclusión de la Vena Retiniana/etiología , Tomografía de Coherencia Óptica , Insuficiencia del TratamientoAsunto(s)
Desprendimiento de Retina/diagnóstico por imagen , Epitelio Pigmentado de la Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Anciano de 80 o más Años , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Degeneración Macular/tratamiento farmacológicoRESUMEN
A 30 year-old man with acute myeloblastic leukaemia and secondary myelodysplastic syndrome developed graft-versus-host disease. The patient was treated with ruxolitinib. After being treated for 3 months with ruxolitinib, an inhibitor of Janus kinase, he developed Aspergillus retinal necrosis resistant to common treatment. Treatment with Janus kinase inhibitors may lead to an increased incidence of opportunistic infections. Janus kinase inhibitor administration may result in poor treatment efficacy.