ABSTRACT
Purpose: This work reports a case of Evans syndrome first presenting with ophthalmic signs. Methods: A 27-year-old previously healthy man presented with headaches and bilateral blurred vision for 2 weeks. The visual acuity was 20/30-1 and 20/60-2 in the right eye and left eye, respectively. A fundus examination revealed Roth spots, diffuse multilayer retinal hemorrhages in the macula and periphery, and tortuous vessels in both eyes. Optical coherence tomography showed a disrupted foveal contour from intraretinal fluid and hemorrhage in both eyes. Fluorescein angiography demonstrated dilated and tortuous vessels with scattered blocking defects from hemorrhages. Results: A workup revealed warm hemolytic anemia with severe thrombocytopenia consistent with the diagnosis of Evans syndrome. Conclusions: Evans syndrome is a rare blood dyscrasia that can first present as subacute vision loss and should be added to the differential of diffuse bilateral retinal hemorrhages spanning a multitude of retinal layers.
Subject(s)
Contrast Sensitivity/drug effects , Gastroesophageal Reflux/drug therapy , Omeprazole/adverse effects , Optic Nerve Diseases/chemically induced , Visual Acuity , Vitamin B 12 Deficiency/complications , Adult , Contrast Sensitivity/physiology , Female , Humans , Omeprazole/therapeutic use , Optic Disk/diagnostic imaging , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/physiopathology , Proton Pump Inhibitors/adverse effects , Proton Pump Inhibitors/therapeutic use , Visual Fields/drug effects , Visual Fields/physiology , Vitamin B 12 Deficiency/diagnosisABSTRACT
BACKGROUND: Report a rare case of retinal capillary macroaneurysm with associated subretinal fluid. CASE PRESENTATION: A 71-year-old male underwent full ophthalmic examination including Optical Coherence Tomography (OCT), Fluorescein Angiography (FA). Fundus examination showed moderate non-proliferative diabetic retinopathy of both eyes with scattered microaneurysms. On initial visit, FA displayed a hyperfluorescent lesion with leakage on late frames in the left eye. OCT revealed the lesion to be spheroid with a hyperreflective wall and hyporeflective lumen in the inner retina, corresponding to a capillary macroaneurysm. Intraretinal cystic fluid surrounded the lesion. On subsequent visit 7 months later, subretinal fluid in the location of the capillary macroaneurysm was noted on OCT. Vision was maintained at 20/30-2 OD, 20/40 OS throughout. No treatment was necessary. CONCLUSION: Subretinal fluid from the capillary macroaneurysm likely developed from its juxtafoveal location and discontinuity of the external limiting membrane (ELM); a barrier preventing flow of intraretinal fluid to the outer retina.
Subject(s)
Aneurysm , Diabetic Retinopathy , Aged , Aneurysm/diagnosis , Fluorescein Angiography , Humans , Male , Retina , Retrospective Studies , Tomography, Optical CoherenceABSTRACT
When prescribing medications, it is important to consider the ocular side effects of common systemic therapy as well as potential systemic side effects of ocular medications. Although not an exhaustive list of medications/classes of medications, this article does include many commonly used drugs and also provides information on some topical therapies commonly used by ophthalmologists. These ocular medications may result in systemic effects and/or alter patients' management of systemic conditions.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Eye Diseases/chemically induced , Eye Diseases/drug therapy , Drug-Related Side Effects and Adverse Reactions/complications , Eye Diseases/etiology , Humans , Ophthalmic Solutions/adverse effects , Ophthalmic Solutions/therapeutic useABSTRACT
Intravitreal anti-VEGF injections are the current gold standard for treating diabetic macular edema (DME). However, injection practice patterns of retina specialists have varied markedly based on physician discretion. This retrospective study analyzes the impact of injection protocol selection on change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) in 170 eyes treated by 4 retina specialists practicing a pro re nata (PRN) strategy between 2010 and 2020. DME patients received an average of 7.25 injections every 6.24 weeks over 56.6 weeks. There were significant differences between retina specialists in mean number of injections (p = 0.0001) and mean length of treatment (p = 0.0007) but not in mean interval between injections. Over the treatment period, average change in BCVA was -0.053 logMAR, and average change in CMT was -51.1 µm, neither of which had significant differences between retina specialists. BCVA and CMT at initial visit were found to be significantly associated with improved BCVA and CMT over the treatment period (p < 0.001). Number of injections administered and interval between injections were not found to be significant factors affecting change in BCVA or CMT. Despite significant differences in injection dosing regimen, retina specialists achieved similar outcomes in change in BCVA and CMT over the treatment period.
Subject(s)
Adrenergic alpha-2 Receptor Agonists/therapeutic use , Blepharoptosis/drug therapy , Brimonidine Tartrate/therapeutic use , Diskectomy/adverse effects , Horner Syndrome/drug therapy , Spinal Fusion/adverse effects , Blepharoptosis/etiology , Female , Horner Syndrome/etiology , Humans , Middle Aged , Postoperative Complications/drug therapy , Postoperative Complications/etiology , Treatment OutcomeABSTRACT
PURPOSE: To report a case of solar retinopathy due to inadvertent exposure to the sun while piloting a drone without protective eyewear. METHODS: A 29-year-old male underwent a complete eye exam including optical coherence tomography (OCT) of the macula. RESULTS: Bilateral juxtafoveal outer retinal microcystic cavities present on OCT consistent with solar retinopathy. CONCLUSION: With the increasing popularity of unmanned aircrafts, eye protection awareness during drone use is essential.
