RESUMEN
The Omi/HtrA2 inhibitor 5-[5-(2-nitrophenyl) furfuryliodine]-1,3-diphenyl-2-thiobarbituric acid (Ucf-101) has shown neuroprotective effects in the central nervous system. However, whether Ucf-101 can protect retinal ganglion cells (RGCs) after retinal ischemia/reperfusion (IR) has not been investigated. We aimed to investigate the effects of Ucf-101 on RGCs apoptosis and inflammation after IR-induced retinal injury in mice. We injected Ucf-101 into the mouse vitreous body immediately after IR injury. After 7 days, hematoxylin and eosin staining was conducted to assess retinal tissue damage. Next, retrograde labeling with FluoroGold, counting of RGCs and TUNEL staining were conducted to evaluate apoptosis. Immunohistochemistry, immunofluorescence staining, and western blotting were conducted to analyze protein levels. IR injury-induced retinal tissue damage could be prevented by Ucf-101 treatment. The number of TUNEL-positive RGCs was reduced by Ucf-101 treatment in mice with IR injury. Ucf-101 treatment inhibited the upregulation of Bax, cleaved caspase-3 and cleaved caspase-9 and activated the JNK/ERK/P38 signaling pathway. Furthermore, Ucf-101 treatment inhibited the upregulation of glial fibrillary acidic protein (GFAP), vimentin, Iba1 and CD68 in mice with IR injury. Ucf-101 prevents retinal tissue damage, improves the survival of RGCs, and suppresses microglial overactivation after IR injury. Ucf-101 might be a potential target to prevent RGCs apoptosis and inflammation in neurodegenerative eye diseases.
Asunto(s)
Apoptosis , Estrés Oxidativo , Daño por Reperfusión , Células Ganglionares de la Retina , Animales , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Ratones , Estrés Oxidativo/efectos de los fármacos , Apoptosis/efectos de los fármacos , Masculino , Células Ganglionares de la Retina/metabolismo , Células Ganglionares de la Retina/patología , Células Ganglionares de la Retina/efectos de los fármacos , Ratones Endogámicos C57BL , Inflamación/patología , Inflamación/metabolismo , Tiobarbitúricos/metabolismo , Retina/metabolismo , Retina/patología , Furanos/farmacología , Retinitis/etiología , Retinitis/patología , Retinitis/metabolismo , Modelos Animales de Enfermedad , Pirimidinonas , TionasRESUMEN
BACKGROUND: Neuroretinitis is classically defined as a clinical triad of unilateral, painless vision loss, accompanied by optic disc edema and characteristic macular star formation. The causes of neuroretinitis can be categorized as infectious, non-infectious, and idiopathic, therefore differential diagnosis and careful evaluation are required, owing to the various etiologies and masqueraders. CASE PRESENTATION: A 54-year-old woman presented to the clinic with blurred vision in both eyes. A complete ophthalmic examination revealed optic disc edema with blurred margins and macular exudates, intraretinal edema in the temporal peripapillary area, and subretinal fluid with neurosensory retinal detachment in the macular area. Systemic laboratory investigations showed no signs of infection or inflammation. However, bone marrow suppression was suspected based on the results of the complete blood count test, and the patient was diagnosed with multiple myeloma. CONCLUSION: Although neuroretinitis is rarely accompanied by hematological malignancy, it is important to be mindful of the latter because ophthalmic manifestations are a common feature of hematological malignancies and lesions occur in nearly every ocular structure.
Asunto(s)
Coriorretinitis , Mieloma Múltiple , Papiledema , Retinitis , Femenino , Humanos , Persona de Mediana Edad , Papiledema/diagnóstico , Papiledema/etiología , Mieloma Múltiple/complicaciones , Mieloma Múltiple/diagnóstico , Retinitis/diagnóstico , Retinitis/etiología , Retinitis/patología , Coriorretinitis/complicaciones , Edema , Trastornos de la Visión/etiologíaRESUMEN
This report presents an atypical case of neuroretinitis in a post-transplant patient. A man in his 40s presented to a provincial ophthalmology service with unilateral left visual loss. He was immunosuppressed following orthotopic liver transplantation for end-stage liver cirrhosis secondary to primary sclerosing cholangitis. He had received his third Pfizer-BioNTech COVID-19 booster vaccine 34 days prior to symptom onset. His presenting left visual acuity was 6/36. His left optic nerve head was grossly swollen with peripapillary haemorrhage, intraretinal and subretinal fluid extending to involve the fovea. His serological and radiological investigations were all negative except for serum IgG and IgM positivity to cytomegalovirus (CMV). Following the commencement of antiviral treatment and systemic steroids, his neuroretinitis improved with visual recovery to 6/4.5. This report describes an atypical presentation of neuroretinitis in an immunocompromised patient without AIDS but with evidence of CMV exposure.
Asunto(s)
Coriorretinitis , Infecciones por Citomegalovirus , Trasplante de Hígado , Retinitis , Masculino , Humanos , Citomegalovirus , Retinitis/diagnóstico , Retinitis/etiología , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/tratamiento farmacológico , Trasplante de Hígado/efectos adversosRESUMEN
Neuroretinitis, originally described by Leber at the turn of the 20th century, has long perplexed ophthalmologists due to its multiple recognized causes and often atypical presentation. Optic disk edema and macular star in the affected eye are well-agreed upon findings and are due to increased permeability of blood vessels near the optic disk and in the retina at large. It also is universally painless and presents with a relative afferent pupillary defect (RAPD) in the affected eye or eyes. However, depending on the infectious agent, an underlying autoimmune condition, or undefined idiopathic cause, there can be various degrees of vision loss, visual field loss, progression or recurrence, as well as involvement of the other eye. We present this case of presumed sequential idiopathic neuroretinitis with severe vision and visual field loss with a low-positive anti-MOG test in the border county of El Paso.
Asunto(s)
Coriorretinitis , Disco Óptico , Retinitis , Humanos , Retinitis/diagnóstico , Retinitis/etiología , Diagnóstico DiferencialRESUMEN
Objectives: To present the clinical and demographic characteristics, imaging findings, diagnosis and treatment approach in cases of cat scratch disease (CSD) with ocular involvement. Materials and Methods: The records of 19 patients followed-up and treated between 2010 and 2020, including detailed ophthalmological examinations, imaging findings, and treatment approach, were evaluated retrospectively. Results: Twenty-three eyes of 19 patients, 7 female (37%) and 12 male (63%), were included in the study. The mean age was 34.1±13.3 (range: 11-56) years, and the mean follow-up duration was 12.6±18.0 (range: 1-81) months. Unilateral involvement was observed in 15 cases (79%). Cat contact was reported in 14 cases (74%). In 6 cases (32%), flu-like symptoms were present before the ocular complaints. The mean visual acuity (VA) at presentation was 0.42±0.36 (range: 0.001-1.0). Anterior uveitis was observed in 3 eyes (13%). Posterior segment findings included neuroretinitis in 14 (61%), superficial retinal infiltrate(s) in 8 (35%), papillitis in 3 (13%), branch retinal artery occlusion in 2 (8%), and cilioretinal artery occlusion in 1 (4%) of the eyes. All cases were positive for Bartonella henselae immunglobulin (Ig)M and/or IgG. Systemic antibiotic therapy was administered to all patients. Intravenous pulse or oral corticosteroids were given, especially in cases with optic disc involvement. The mean final VA was 0.80±0.25 (range: 0.01-1.0). Conclusion: CSD may present with different ocular involvement patterns. Apart from the classical neuroretinitis and macular star appearance, patients may present with isolated optic disc edema, branch retinal artery occlusion, and retinal infiltrations. In such patients, cat contact history and Bartonella serology should be evaluated to differentiate CSD.
Asunto(s)
Enfermedad por Rasguño de Gato , Coriorretinitis , Oclusión de la Arteria Retiniana , Retinitis , Femenino , Masculino , Humanos , Enfermedad por Rasguño de Gato/complicaciones , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Estudios Retrospectivos , Retina , Retinitis/diagnóstico , Retinitis/etiologíaAsunto(s)
Retinitis , Sífilis , Humanos , Sífilis/complicaciones , Sífilis/diagnóstico , Retinitis/diagnóstico , Retinitis/etiologíaRESUMEN
BACKGROUND: Epidemic retinitis occurs seasonally following febrile infections in endemic regions. Rift valley fever (RVF) is endemic to Sudan, with a recent outbreak starting in 2019. METHODS: Retrospective case series of 3 patients travelling from Sudan with post-febrile retinitis, and with a history and clinical picture suggestive of RVF retinitis. RESULTS: The three patients were adult males with underlying medical conditions and underwent fundus fluorescein angiography that confirmed bilateral retinitis and occlusive vasculitis involving the posterior pole. Optical coherence tomography showed distortion of the macular layers. Case 2 presented 1 month following febrile illness and had retinal thinning, with optical coherence tomography angiography showing marked reduction in vessel density. CONCLUSION: We present multimodal imaging data of three cases with presumed RVF retinitis from a recent outbreak in Sudan. The unavailability of standardized methods of testing for RVF, as is the case for most epidemic retinitis-causing pathogens, makes the diagnosis challenging.
Asunto(s)
Retinitis , Fiebre del Valle del Rift , Masculino , Adulto , Animales , Humanos , Fiebre del Valle del Rift/complicaciones , Fiebre del Valle del Rift/epidemiología , Sudán/epidemiología , Estudios Retrospectivos , Retinitis/diagnóstico , Retinitis/etiología , Brotes de EnfermedadesRESUMEN
Purpose: To report ocular findings in a case of atypical fulminant SSPECase report: A 20-year-old male who came with macular necrotising retinitis in both his eyes in absence of any neurological feature. Within a week the patient developed dystonic posturing and seizures. CSF examination revealed raised measles antibody titres and EEG was suggestive of SSPE. The patient succumbed to the disease within 35 days of presentation.Conclusion: SSPE can rarely have a rapidly progressive downhill course without typical neurological features and ophthalmic features which appear to be more consistent may help in clinching the diagnosis in these cases.
Asunto(s)
Sarampión , Retinitis , Panencefalitis Esclerosante Subaguda , Masculino , Humanos , Adulto Joven , Adulto , Panencefalitis Esclerosante Subaguda/diagnóstico , Sarampión/diagnóstico , Retinitis/diagnóstico , Retinitis/etiología , Ojo , Diagnóstico Diferencial , ElectroencefalografíaRESUMEN
PURPOSE: To study clinical and imaging features of presumed post-COVID infection retinitis. METHOD: Retrospective case series of patients presenting with retinitis lesions with evidence of recent COVID infection. Retinal findings and optical coherence tomography (OCT) features were studied at baseline and follow-ups. RESULTS: Twenty-four eyes of 17 patients were included. Mean age was 36.57 ± 11.78 years. Baseline visual acuity (VA) was log MAR 0.97 ± 0.43. Fundus findings included retinitis patches (n = 24),hard exudates (n = 8), and superficial hemorrhages (n = 16). OCT features included neurosensory detachment (NSD, n = 20), hyperreflective inner layers (n = 24), acute macular neuroretinopathy (AMN, n = 8), hyperreflective foci (n = 20). At final follow-up, VA was logMAR 0.43 ± 0.27. Retinitis patches persisted in four eyes, AMN in three eyes, and NSD in five eyes. Conclusion- Post- COVID infection retinitis adds to existing literature on post COVID syndromes.
Asunto(s)
COVID-19 , Retinitis , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Retrospectivos , COVID-19/complicaciones , COVID-19/diagnóstico , Retina , Tomografía de Coherencia Óptica/métodos , Retinitis/diagnóstico , Retinitis/etiología , Angiografía con Fluoresceína/métodosRESUMEN
PURPOSE: To report the fundus photographs and spectral domain optical coherence tomography (SD-OCT) findings of a patient with subacute sclerosing panencephalitis (SSPE) presenting merely with ocular symptoms. CASE REPORT: A 20-year-old patient presented with sudden loss of vision in the left eye (LE). Fundus photograph showed a yellow lesion in the macula and SD-OCT showed increased reflectivity of the inner retinal layers. Disorganization of the necrotizing retinal layers in the LE gradually progressed to the atrophic retina. Then, visual complaints began in the right eye (RE) accompanied by neurological symptoms. SD-OCT revealed the inner and outer plexiform layers edema and interruption of the ellipsoid zone in RE. Fundus photographs showed macular atrophy for both eyes on the day patient died. CONCLUSION: This case report demonstrates the SD-OCT findings of SSPE retinitis with close follow-up from the acute retinitis to the total atrophic macula. These unique findings may be considered as characteristical for the diagnosis.
Asunto(s)
Mácula Lútea , Retinitis , Panencefalitis Esclerosante Subaguda , Humanos , Adulto Joven , Adulto , Panencefalitis Esclerosante Subaguda/complicaciones , Panencefalitis Esclerosante Subaguda/diagnóstico , Panencefalitis Esclerosante Subaguda/patología , Tomografía de Coherencia Óptica/métodos , Retinitis/diagnóstico , Retinitis/etiología , Retina/patología , Mácula Lútea/patología , Angiografía con Fluoresceína/métodosRESUMEN
PURPOSE: To present a case of neuroretinitis following an mRNA COVID-19 vaccination. CASE REPORT: A 78-year-old healthy woman was presented with blurry vision in her left eye 1 day after receiving the third dose of the Pfizer-BioNTech COVID-19 vaccine. The ocular examination revealed an optic disc swelling and retinal thickening of the macula with subretinal fluid in the left eye. The fluorescein angiography revealed hyperfluorescence of the left optic disc. The neuroretinitis resolved gradually after taking azithromycin and prednisolone orally. CONCLUSIONS: This is the first report of unilateral neuroretinitis following COVID-19 vaccination, implying a potential association between the mRNA vaccine and neuroretinitis.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Coriorretinitis , Retinitis , Anciano , Femenino , Humanos , Vacuna BNT162 , Vacunas contra la COVID-19/efectos adversos , Retinitis/diagnóstico , Retinitis/tratamiento farmacológico , Retinitis/etiología , Vacunación/efectos adversosRESUMEN
SIGNIFICANCE: Severe vision loss from Bartonella neuroretinitis can be best treated to improve visual outcomes with a combination of systemic corticosteroids and antibiotics. Topical ketorolac 0.5% and difluprednate 0.05% are presented as a new adjunct therapy to potentially improve visual outcomes. PURPOSE: This case illustrates severe posterior pole complications that can occur with cat scratch disease disseminated to the eye. Combination therapy with antibiotics and corticosteroids results in better visual outcomes. Topical treatment might further enhance visual outcome by preventing inflammatory damage without significant immunosuppression. CASE REPORT: A 17-year-old male teenager presented with right eye vision loss. He had been hospitalized 2 weeks prior for optic neuritis and treated with intravenous methylprednisolone. After 3 days, vision had improved from 20/200 to 20/40. After positive serology for Bartonella henselae was obtained, he was released and treated with oral rifampin, doxycycline, and prednisone. Sixteen days later, he regressed to 20/200, and many more ophthalmic complications were observed. After discontinuation of rifampin, oral prednisone was continued for an additional 2 weeks, and doxycycline was continued for approximately 3 weeks. Topical drops ketorolac 0.5% twice a day and difluprednate 0.05% four times a day were used for more than 6 weeks before tapering after vision returned to normal. CONCLUSIONS: Bartonella neuroretinitis associated with pre-retinal hemorrhage, vitritis, and subretinal hemorrhage can be successfully treated with a combination of systemic medications and topical drops. Monotherapy with doxycycline is effective and well tolerated. Rifampin can cause rapid metabolization and reduction in plasma levels of both prednisone and doxycycline and should be avoided with combined therapy. Oral prednisone and topical difluprednate are recommended to quell initial inflammation during the first few weeks. The anti-inflammatory effects of doxycycline and topical ketorolac used for longer duration may be beneficial in preventing tissue damage without systemic immunosuppression and result in better visual outcomes.
Asunto(s)
Enfermedad por Rasguño de Gato , Coriorretinitis , Retinitis , Antibacterianos/uso terapéutico , Enfermedad por Rasguño de Gato/complicaciones , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Doxiciclina/uso terapéutico , Quimioterapia Combinada , Humanos , Ketorolaco/uso terapéutico , Masculino , Prednisona/uso terapéutico , Retinitis/diagnóstico , Retinitis/tratamiento farmacológico , Retinitis/etiología , Rifampin/uso terapéuticoRESUMEN
Neuroretinitis due to Bartonella henselae infection is a rare cause of vision loss in children. Two pediatric cases of acute unilateral vision loss accompanied by edema of the optic nerve on fundoscopic examination are presented. Severe causes of vision loss were excluded. During the course of the disease, macular stellate exudates emerged on control fundoscopic examinations, and diagnosis of neuroretinitis was made. A causative agent was confirmed by serologic examination, as high titers of IgM and IgG antibodies to Bartonella henselae were detected. Both patients significantly recovered after oral antibiotic treatment.
Asunto(s)
Bartonella henselae , Enfermedad por Rasguño de Gato , Infecciones Bacterianas del Sistema Nervioso Central , Neurología , Papiledema , Retinitis , Ceguera/complicaciones , Enfermedad por Rasguño de Gato/complicaciones , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Niño , Humanos , Papiledema/complicaciones , Retinitis/complicaciones , Retinitis/etiologíaRESUMEN
PURPOSE: To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis. METHODS: Narrative review. RESULTS: Posterior segment OCT in patients with infectious uveitis reveals posterior hyaloid face precipitates, superficial retinal precipitates and infiltrates, foveolitis, retinitis, neuro-retinitis, choroidal granulomas, and choroiditis as main imaging biomarkers. Some of these features are specific to the underlying causing etiology and may support the diagnosis and the initiation of treatment. Some OCT features disappear completely with resolution; some others are associated with irreversible retinal damage. CONCLUSIONS: OCT identifies different features of infectious uveitis into the vitreous, the retina, and the choroid. OCT characteristics, combined with other multimodal imaging features, are helpful in the differential diagnosis of infectious uveitis, the early detection of complications, and the assessment of the response to therapy.
Asunto(s)
Infecciones del Ojo , Retinitis , Uveítis Posterior , Uveítis , Coroides , Infecciones del Ojo/complicaciones , Angiografía con Fluoresceína/métodos , Humanos , Retinitis/etiología , Tomografía de Coherencia Óptica/métodos , Uveítis/complicaciones , Uveítis/diagnóstico , Uveítis Posterior/complicaciones , Uveítis Posterior/diagnósticoRESUMEN
INTRODUCTION: The most distinctive patterns of posterior pole affectation in syphilitic patients are acute posterior placoid chorioretinitis (ASPPC), pseudoretinitis pigmentosa and panuveitis with white focal preretinal opacities. However, outer retinitis is not a common presenting feature in this disease. CASE REPORT: Thus, we report an atypical case of syphilitic outer retinitis (SOR) and severe retinal phlebitis as presenting manifestations in a patient with HIV and syphilis coinfection. We consider that this patient had mixed characteristics of SOR and ASPPC with features of acute zonal occult outer retinopathy (AZOOR) spectrum, which has only rarely been published in recent years. CONCLUSION: Prompt and appropriate antibiotic treatment permitted total restoration of the external retinal layers, resolution of retinal vasculitis and recuperation of visual acuity. Since SOR is treatable in contrast to AZOOR, ophthalmologists should be aware that SOR needs to be ruled out when making a diagnosis of AZOOR.
Asunto(s)
Infecciones Bacterianas del Ojo , Infecciones por VIH , Vasculitis Retiniana , Retinitis , Sífilis , Infecciones Bacterianas del Ojo/complicaciones , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Angiografía con Fluoresceína , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Humanos , Vasculitis Retiniana/diagnóstico , Vasculitis Retiniana/tratamiento farmacológico , Vasculitis Retiniana/etiología , Retinitis/diagnóstico , Retinitis/tratamiento farmacológico , Retinitis/etiología , Sífilis/complicaciones , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Tomografía de Coherencia ÓpticaRESUMEN
PURPOSE: To describe a case of outer retinitis with frosted branch angiitis associated with mumps infection treated with hyperbaric oxygen (HBO) therapy. METHODS: Observational case report. CASE REPORT: A four-year-old boy with bilateral blindness was diagnosed with necrotizing outer retinitis with frosted branch angiitis associated with serologically confirmed mumps virus infection. He was treated with HBO therapy. Visual acuity subsequently improved to 20/40 in the right eye and to 20/320 in the left eye. Sequential follow-up optical coherence tomography examinations showed progressive recovery of the outer retinal layers in the right eye. CONCLUSION: HBO therapy appears to be a feasible and safe treatment that might improve the anatomical and functional outcome in patients with mumps retinitis.