RESUMEN
A 12-year-old male presented for evaluation of asymptomatic bilateral retinal tumors. Both eyes contained whitish-gray retinal tumors with intralesional calcifications. Enhanced depth optical coherence tomography and high-resolution (20 MHz) ultrasonography narrowed the differentiation diagnosis to astrocytic hamartoma versus retinocytoma. Genetic testing of a saliva sample was negative for tuberous sclerosis complex but positive for a novel mutation in the retinoblastoma gene (RB1). Taken together, these findings were consistent with a diagnosis of bilateral retinocytoma in a patient with germline RB1 mutation. This case demonstrates the importance of combining clinical imaging and genetic testing in the evaluation of bilateral intraocular tumors. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:812-814.].
Asunto(s)
Pruebas Genéticas/métodos , Imagen Multimodal/métodos , Neoplasias de la Retina/diagnóstico , Tomografía de Coherencia Óptica , Niño , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
BACKGROUND AND OBJECTIVE: To evaluate the efficacy of ranibizumab in the treatment of choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome. PATIENTS AND METHODS: Patients enrolled in the ranibizumab group received a monthly intravitreal injection of 0.5 mg of ranibizumab. Patients in the photodynamic therapy (PDT) group received a quarterly dosing of intravenous verteporfin coupled with PDT. RESULTS: Mean change in ETDRS visual acuity at 1 year was 19.6 letters in the ranibizumab group versus 21 letters in the PDT group. All patients in the PDT group required rescue ranibizumab therapy. Four of five patients (80%) in the ranibizumab group and one of two patients (50%) in the PDT group showed a greater than 15 letter gain at 1 year. CONCLUSION: Ranibizumab appears to be a safe and effective treatment option for choroidal neovascularization secondary to the presumed ocular histoplasmosis syndrome.
Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Neovascularización Coroidal/terapia , Histoplasmosis/terapia , Fotoquimioterapia , Adulto , Anciano , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/microbiología , Femenino , Angiografía con Fluoresceína , Histoplasmosis/diagnóstico , Histoplasmosis/microbiología , Humanos , Inyecciones Intravenosas , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Fármacos Fotosensibilizantes/uso terapéutico , Porfirinas/uso terapéutico , Ranibizumab , Síndrome , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Verteporfina , Agudeza Visual/fisiologíaAsunto(s)
Bartonella henselae/aislamiento & purificación , Enfermedad por Rasguño de Gato/diagnóstico , Infecciones Bacterianas del Ojo/diagnóstico , Granuloma/diagnóstico , Síndrome de Horner/diagnóstico , Enfermedades de la Retina/diagnóstico , Anticuerpos Antibacterianos/sangre , Azitromicina/uso terapéutico , Bartonella henselae/inmunología , Parálisis de Bell/diagnóstico , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Enfermedad por Rasguño de Gato/microbiología , Niño , Quimioterapia Combinada , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Bacterianas del Ojo/microbiología , Femenino , Fiebre de Origen Desconocido/diagnóstico , Glucocorticoides/uso terapéutico , Granuloma/tratamiento farmacológico , Granuloma/microbiología , Humanos , Inmunoglobulina G/sangre , Prednisona/uso terapéutico , Enfermedades de la Retina/tratamiento farmacológico , Enfermedades de la Retina/microbiología , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/tratamiento farmacológico , Trastornos de la Visión/microbiología , Agudeza VisualRESUMEN
PURPOSE: To report a case of herpes simplex virus-induced herpetic necrotizing retinitis after placement of a flucinolone acetonide (Retisert) intravitreal implant. DESIGN: Interventional case report. METHODS: Retrospective chart review. RESULTS: A 22-year-old male with idiopathic unilateral panuveitis since 2002 that was intolerant of systemic immunosuppressive therapy received a flucinolone acetonide implant 6 years later. Intraocular inflammation was completely quiescent until 1 year following the implant, when he developed retinitis. To the authors' knowledge, this is the first reported case of polymerase chain reaction-proven herpetic necrotizing retinitis following implantation of a Retisert device. CONCLUSIONS: Although rare, herpetic necrotizing retinitis can occur in the setting of local ocular immunosuppression with the Retisert intravitreal implant. This potential infection should be considered in the face of recurrent uveitis following Retisert implantation.