In immunocompromised patients, toxoplasmosis may have atypical presentation with bilateral, extensive or multifocal involvement. We report a case series of atypical toxoplasmic retinocoroiditis in patients with malignant hematological diseases who are usually immunosuppressed. Four patients were diagnosed of atypical toxoplasmic retinochoroiditis, all of them had immunosuppression (100%) and half of them (50%) had received a bone marrow transplant. The polymerase chain reaction for toxoplasma was positive in 75% of cases, and in one case (25%) the diagnosis was made with clinical and serological criteria. One patient presented ocular toxoplasmosis despite being on prophylactic treatment with atovaquone. Patients with atypical ocular toxoplasmosis and hematological diseases are generally immunocompromised, but they do not always have history of a bone marrow transplant. The presentation may be due to a primary infection or a reactivation of the disease. The aqueous humor and/or vitreous polymerase chain reaction allow confirming the diagnosis to perform a proper treatment.
Intravitreal Injections/adverse effects , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Retinal Pigment Epithelium/injuries , Aged, 80 and over , Angiogenesis Inhibitors/administration & dosage , Disease Progression , Female , Humans , Lacerations/diagnosis , Lacerations/etiology , Macular Degeneration/complications , Macular Degeneration/diagnosis , Macular Degeneration/drug therapy , Ranibizumab/administration & dosage , Retinal Perforations/pathology , Retinal Pigment Epithelium/pathology
PURPOSE: To observe trends in surgical techniques for corneal transplantation and main indications in our hospital over the past five years. METHODS: Retrospective descriptive study, including all keratoplasties performed at the Hospital Clinic of Barcelona, Spain, between January 2014 and December 2018. RESULTS: In total, 332 keratoplasties were performed. In total, 127 (38.25%) were penetrating keratoplasties (PK), and 205 (61.75%) were lamellar keratoplasties (LK). In 2014, a total of 48 keratoplasties were carried-out, whereas in 2018, the total was 93, which represents a 93.75% increase in corneal transplantation surgeries. Eye bank-delivered precut tissue for DMEK was introduced in 2016, and 3 cases (6.25%), were carried out that year. In 2018, DMEK became the leading technique with 56 cases (60.22%). Fuchs' dystrophy was the leading indication for corneal transplant (37.63%) in 2018. CONCLUSION: Introduction of DMEK in a single center can be implemented in a relatively short period of time, becoming the most popular surgical procedure in corneal transplantation. A possible factor encouraging this change is the availability of eye bank-delivered precut tissue, and standardization of donor preparation and host surgical steps, optimizing surgical time in the operating room. This trend should lead to better visual outcomes, faster recovery times, and eventually to a higher surgical volume per year.
Corneal Diseases/surgery , Corneal Transplantation/trends , Descemet Stripping Endothelial Keratoplasty/trends , Adult , Aged , Aged, 80 and over , Corneal Diseases/epidemiology , Corneal Transplantation/methods , Corneal Transplantation/statistics & numerical data , Descemet Membrane/surgery , Descemet Stripping Endothelial Keratoplasty/methods , Endothelium, Corneal/surgery , Endothelium, Corneal/transplantation , Female , Fuchs' Endothelial Dystrophy/epidemiology , Fuchs' Endothelial Dystrophy/surgery , Humans , Keratoplasty, Penetrating/methods , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Retrospective Studies , Spain/epidemiology , Tissue Donors
Aging/pathology , Multimodal Imaging , Retinoschisis/diagnosis , Female , Humans , Macular Degeneration/complications , Macular Degeneration/diagnosis , Macular Degeneration/pathology , Middle Aged , Multimodal Imaging/methods , Optical Imaging , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/pathology , Retinoschisis/complications , Retinoschisis/pathology , Tomography, Optical Coherence , Ultrasonography
Glaucoma Drainage Implants , Glaucoma, Open-Angle/surgery , Intraocular Pressure/physiology , Stents , Tenon Capsule/pathology , Aged , Female , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/physiopathology , Humans , Tenon Capsule/diagnostic imaging , Tomography, Optical Coherence , Tonometry, Ocular , Treatment Outcome